| NPI | 1780560938 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program (Licence: KY 1119442) |
| Additional Taxonomies | 163WP0808X Registered Nurse, Psych/Mental Health (Licence: KY 1119442) |
| Enumeration Date | 2025-08-13 |
| Last Update Date | 2025-08-13 |