| NPI | 1225812969 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: TN 36299) | 
| Additional Taxonomies | 163WP0808X Registered Nurse, Psych/Mental Health (Licence: TN 234746) | 
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: KY 4015713) | |
| Enumeration Date | 2023-08-23 | 
| Last Update Date | 2024-09-20 |