| NPI | 1073736039 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: KS 53-46236) |
| Additional Taxonomies | 163WP0808X Registered Nurse, Psych/Mental Health (Licence: KS 13-92881-061) |
| Enumeration Date | 2007-04-10 |
| Last Update Date | 2017-02-27 |