| NPI | 1174275077 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: IN 71012305A) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: KY 4000692) |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: IN 28220595A) | |
| Enumeration Date | 2022-01-21 |
| Last Update Date | 2023-04-26 |