| NPI | 1790734556 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: KY 1869) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: KY 1055267) |
| Enumeration Date | 2006-05-09 |
| Last Update Date | 2017-12-15 |