| NPI | 1972867695 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: CT 003777) |
| Additional Taxonomies | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: NY F401504) |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: CT 3777) | |
| Enumeration Date | 2012-06-27 |
| Last Update Date | 2020-05-28 |