| NPI | 1750625539 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: TN 17018) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TN 17018) |
| 363LF0000X Nurse Practitioner, Family (Licence: VA 0024171150) | |
| Enumeration Date | 2012-11-19 |
| Last Update Date | 2025-05-12 |