| NPI | 1174766489 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: KY 3006016)  | 
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: KY 3006016)  | 
| Enumeration Date | 2009-04-16 | 
| Last Update Date | 2022-06-07 |