| NPI | 1154058675 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: KY 3018122) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: KY 3018122) |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: OR 10025052) | |
| Enumeration Date | 2022-08-04 |
| Last Update Date | 2024-06-04 |