| NPI | 1053806380 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: SC 22058) |
| Additional Taxonomies | 163WP0808X Registered Nurse, Psych/Mental Health (Licence: TN RN0000204913) |
| Enumeration Date | 2018-06-28 |
| Last Update Date | 2018-08-13 |