| NPI | 1275030017 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: KS 53-78702-012) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: KS 14-148365-012) |
| Enumeration Date | 2018-04-09 |
| Last Update Date | 2020-04-01 |