| NPI | 1104309939 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: KY 3012809) |
| Additional Taxonomies | 163WG0000X Registered Nurse, General Practice (Licence: KY 1145939) |
| Enumeration Date | 2018-09-07 |
| Last Update Date | 2018-10-19 |