| NPI | 1619272036 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: TN 15265) |
| Additional Taxonomies | 363LP2300X Nurse Practitioner, Primary Care (Licence: TN 15265) |
| Enumeration Date | 2011-01-15 |
| Last Update Date | 2021-09-24 |