| NPI | 1790405967 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: TN 32092) |
| Additional Taxonomies | 363LP2300X Nurse Practitioner, Primary Care (Licence: TN 32092) |
| Enumeration Date | 2022-08-29 |
| Last Update Date | 2025-01-24 |