| NPI | 1124850466 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: TN 36721) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: TN 36721) |
| Enumeration Date | 2024-08-15 |
| Last Update Date | 2025-05-05 |