| NPI | 1699039248 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: NC 5016185) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: KY 3007523) |
| Enumeration Date | 2012-06-28 |
| Last Update Date | 2025-05-13 |