| NPI | 1093264871 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: KS 77342) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: KS 77342) |
| 363LF0000X Nurse Practitioner, Family (Licence: MO 2016032489) | |
| Enumeration Date | 2016-09-22 |
| Last Update Date | 2023-09-13 |