| NPI | 1164841821 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: TN 244335) |
| Additional Taxonomies | 164W00000X Licensed Practical Nurse (Licence: TN 79341) |
| Enumeration Date | 2014-04-09 |
| Last Update Date | 2026-05-14 |