| NPI | 1790230183 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: TN 21616) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: TN 176667) |
| Enumeration Date | 2016-08-16 |
| Last Update Date | 2016-10-26 |