| NPI | 1053847970 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: TN 23590) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: TN 0000210200) |
| Enumeration Date | 2017-05-11 |
| Last Update Date | 2018-02-07 |