| NPI | 1619520269 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: KY 3013663) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: KY 3013663) |
| Enumeration Date | 2019-07-23 |
| Last Update Date | 2023-07-10 |