| NPI | 1790091080 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: KY 3006552) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: KY 3006552) |
| Enumeration Date | 2010-08-24 |
| Last Update Date | 2016-02-22 |