| NPI | 1710412614 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: KY 3011434) |
| Additional Taxonomies | 163WP0808X Registered Nurse, Psych/Mental Health (Licence: KY 1093016) |
| Enumeration Date | 2017-04-28 |
| Last Update Date | 2018-03-17 |