| NPI | 1104393925 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: KY 3012601)  | 
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: KY 3012601)  | 
| Enumeration Date | 2018-10-30 | 
| Last Update Date | 2024-03-26 |