| NPI | 1174549984 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: TN 0000012367) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: NY F333106) |
| 363LP0808X Nurse Practitioner Psychiatric/Mental Health (Licence: TN 0000012367) | |
| Enumeration Date | 2006-07-14 |
| Last Update Date | 2021-10-06 |