| NPI | 1083206742 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: KY 3015815) |
| Additional Taxonomies | 163WP0808X Registered Nurse, Psych/Mental Health (Licence: KY 1130985) |
| Enumeration Date | 2021-02-04 |
| Last Update Date | 2023-02-10 |