| NPI | 1043340169 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: GA RN207891) |
| Additional Taxonomies | 164W00000X Licensed Practical Nurse (Licence: KY 2040533) |
| Enumeration Date | 2007-03-07 |
| Last Update Date | 2022-10-21 |