| NPI | 1396164158 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MO 2019043528) |
| Additional Taxonomies | 163WP0809X Registered Nurse, Psych/Mental Health, Adult (Licence: KS 110787) |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: KS 79080) | |
| Enumeration Date | 2014-04-09 |
| Last Update Date | 2020-05-28 |