| NPI | 1770122459 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: KS 5379150091) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: KS 53-79150-091) |
| Enumeration Date | 2019-12-30 |
| Last Update Date | 2026-01-02 |