| NPI | 1770624900 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner Psychiatric/Mental Health (Licence: KY 3005386) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: KY 1043709) |
| Enumeration Date | 2007-02-09 |
| Last Update Date | 2011-01-11 |