| NPI | 1457121360 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: TN 25521) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: TN 25521) |
| 363LP0200X Nurse Practitioner, Pediatrics (Licence: TN 25521) | |
| Enumeration Date | 2024-01-03 |
| Last Update Date | 2024-01-03 |