| NPI | 1831557578 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: KY 3010101) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: KY 3010101) |
| 363LF0000X Nurse Practitioner, Family (Licence: KY 3010101) | |
| Enumeration Date | 2016-02-09 |
| Last Update Date | 2020-01-10 |