| NPI | 1679664411 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: TN 6350) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TN 6350) |
| 363LP0200X Nurse Practitioner, Pediatrics (Licence: TN 6350) | |
| Enumeration Date | 2006-09-27 |
| Last Update Date | 2020-07-23 |