| NPI | 1508309329 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: MO 2007018588) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: MO 2007018588) |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: KS 78074) | |
| Enumeration Date | 2016-11-28 |
| Last Update Date | 2023-04-05 |