| NPI | 1396176640 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner Psychiatric/Mental Health (Licence: KY 3019108) |
| Additional Taxonomies | 164W00000X Licensed Practical Nurse (Licence: KY 2049387) |
| Enumeration Date | 2013-12-11 |
| Last Update Date | 2023-12-07 |