| NPI | 1003404534 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: KY 3016004) |
| Additional Taxonomies | 363LP2300X Nurse Practitioner, Primary Care (Licence: KY 3016004) |
| Enumeration Date | 2021-01-10 |
| Last Update Date | 2024-04-22 |