| NPI | 1982252524 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: TN 35587) |
| Additional Taxonomies | 133V00000X Dietitian, Registered (Licence: TN 0000002504) |
| Enumeration Date | 2019-08-27 |
| Last Update Date | 2024-03-07 |