| NPI | 1164807186 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: TN 20168) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TN 20168) |
| Enumeration Date | 2015-07-21 |
| Last Update Date | 2025-11-12 |