| NPI | 1205974714 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: ND R47305) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: KS 1066LMLP) |
| 163W00000X Registered Nurse (Licence: KS RN-13-112168-012) | |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: KS 76075) | |
| Enumeration Date | 2007-02-05 |
| Last Update Date | 2019-08-19 |