| NPI | 1760506695 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TN 15306) |
| Additional Taxonomies | 163WP0808X Registered Nurse, Psych/Mental Health (Licence: TN RN0000155633) |
| Enumeration Date | 2007-03-17 |
| Last Update Date | 2010-11-22 |