| NPI | 1558347112 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: KS 53-45042-111) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: KS 1465753111) |
| 363L00000X Nurse Practitioner (Licence: KS 45042) | |
| Enumeration Date | 2005-12-15 |
| Last Update Date | 2026-07-01 |