| NPI | 1053732099 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: TN APN0000017939) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TN APN0000017939) |
| Enumeration Date | 2013-12-17 |
| Last Update Date | 2015-10-07 |