| NPI | 1194003707 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner Psychiatric/Mental Health (Licence: KS 53-75113-021) |
| Additional Taxonomies | 1041C0700X Social Worker Clinical (Licence: KS 4468) |
| 163WP0808X Registered Nurse Psychiatric/Mental Health (Licence: KS 5375113021) | |
| 2084P0800X Psychiatry & Neurology Psychiatry (Licence: KS 53-75113-021) | |
| Enumeration Date | 2011-07-31 |
| Last Update Date | 2022-06-20 |