| NPI | 1164805701 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KY 3009279) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: KY 3009379) |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: KY 3009279) | |
| Enumeration Date | 2015-07-01 |
| Last Update Date | 2024-06-17 |