| NPI | 1780980623 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: TN 14716) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TN 14716) |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: TN 14716) | |
| Enumeration Date | 2011-02-09 |
| Last Update Date | 2020-02-26 |