| NPI | 1629375019 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: KS 53-75321) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: KS 5375321) |
| Enumeration Date | 2011-02-21 |
| Last Update Date | 2015-10-09 |