| NPI | 1871041954 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: KY 3010631) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: KY 3010631) |
| 363LP0808X Nurse Practitioner Psychiatric/Mental Health (Licence: KY 3010631) | |
| Enumeration Date | 2016-09-16 |
| Last Update Date | 2023-10-10 |