| NPI | 1376944462 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: TN 19107) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: TN 19107) |
| 363LF0000X Nurse Practitioner, Family (Licence: TN 19107) | |
| Enumeration Date | 2014-09-09 |
| Last Update Date | 2019-11-15 |