| NPI | 1407197635 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: KY 3007891) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: KY 3007981) |
| 363LA2200X Nurse Practitioner, Adult Health (Licence: KY 3007981) | |
| Enumeration Date | 2013-03-13 |
| Last Update Date | 2025-02-27 |