| NPI | 1083673792 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: TN 5767) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MS 95007768) |
| 363LF0000X Nurse Practitioner Family (Licence: MS R617601) | |
| 363LP0808X Nurse Practitioner Psychiatric/Mental Health (Licence: TN 5767) | |
| Enumeration Date | 2006-03-21 |
| Last Update Date | 2020-04-06 |