| NPI | 1154106508 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: VA 0024190179) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: TN 34596) |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: TN 34596) | |
| Enumeration Date | 2023-08-25 |
| Last Update Date | 2024-10-12 |