| NPI | 1497266563 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: TN 23382) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: KY 1096373) |
| Enumeration Date | 2017-10-17 |
| Last Update Date | 2017-10-27 |