| NPI | 1083649495 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: KY 3004320) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: KY 3004320) |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: KY 3004320) | |
| Enumeration Date | 2006-07-12 |
| Last Update Date | 2024-01-05 |