| NPI | 1285068684 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: KS 76016) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: KS 53-76016-041) |
| Enumeration Date | 2013-08-21 |
| Last Update Date | 2020-08-04 |