| NPI | 1245629815 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: KS 53-76665-061) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: KS 13-119579-061) |
| Enumeration Date | 2015-01-20 |
| Last Update Date | 2022-01-06 |