| NPI | 1134169584 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MO 2014037913) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: KS 45148) |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: KS NP 53-45148-071) | |
| Enumeration Date | 2006-06-07 |
| Last Update Date | 2016-09-22 |