| NPI | 1912563610 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: CT 9945) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: OR 201809233RN) |
| Enumeration Date | 2019-05-17 |
| Last Update Date | 2021-09-29 |