| NPI | 1194112755 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: KY 3009854) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TN 19931) |
| Enumeration Date | 2015-04-22 |
| Last Update Date | 2022-10-18 |