| NPI | 1699791251 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MO 2004024623) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MO 2004024623) |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: KS 53-45880-091) | |
| 363LF0000X Nurse Practitioner, Family (Licence: KS 45880) | |
| Enumeration Date | 2006-07-15 |
| Last Update Date | 2025-09-03 |