| NPI | 1346911526 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KS 53-80446-052) |
| Additional Taxonomies | 261QM0850X Clinic/Center, Adult Mental Health (Licence: KS 53-80446-052) |
| Enumeration Date | 2021-09-27 |
| Last Update Date | 2026-06-23 |