| NPI | 1396103404 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: KY 3010078) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: KY 3010078) |
| 363LF0000X Nurse Practitioner, Family (Licence: KY 3010078) | |
| Enumeration Date | 2016-02-03 |
| Last Update Date | 2025-10-27 |