| NPI | 1083468391 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: KS 53-84150-091) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: KS 136521) |
| Enumeration Date | 2024-04-15 |
| Last Update Date | 2025-03-28 |