| NPI | 1649714197 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: KY 3012528) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: IN 71006746A) |
| 363LP0808X Nurse Practitioner Psychiatric/Mental Health (Licence: KY 3012528) | |
| Enumeration Date | 2016-12-16 |
| Last Update Date | 2025-08-26 |