| NPI | 1124450127 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: KS 53-44715-081) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: KS 53-44715-081) |
| 363LP0200X Nurse Practitioner, Pediatrics (Licence: MO 073678) | |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MO 2023035005) | |
| Enumeration Date | 2013-08-01 |
| Last Update Date | 2023-08-25 |