| NPI | 1790238186 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: KS 53-83781-071) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: KS 130974) |
| Enumeration Date | 2016-08-02 |
| Last Update Date | 2025-09-08 |