| NPI | 1174285324 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: KY 3016103) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: KY 3016103) |
| 363LF0000X Nurse Practitioner, Family (Licence: VA 0024181626) | |
| Enumeration Date | 2021-10-05 |
| Last Update Date | 2025-03-03 |