| NPI | 1578812707 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KY 3007674) |
| Additional Taxonomies | 261QM0850X Clinic/Center, Adult Mental Health (Licence: IN 1078784) |
| 261QP2300X Clinic/Center, Primary Care (Licence: KY 1078784) | |
| Enumeration Date | 2012-09-04 |
| Last Update Date | 2018-12-27 |