| NPI | 1811214653 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: TN APN0000014722) |
| Additional Taxonomies | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: TN APN0000014722) |
| Enumeration Date | 2010-05-03 |
| Last Update Date | 2011-05-05 |