| NPI | 1285269340 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: KY 3014519) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: KY 1126802) |
| 363L00000X Nurse Practitioner (Licence: KY 3014519) | |
| Enumeration Date | 2020-03-10 |
| Last Update Date | 2021-07-27 |