| NPI | 1659830107 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner Psychiatric/Mental Health (Licence: TN 28387) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: TN 28387) |
| 163W00000X Registered Nurse (Licence: TN 0000186093) | |
| Enumeration Date | 2019-03-14 |
| Last Update Date | 2020-11-02 |