| NPI | 1871152199 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: KY 3014036) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: IN F06190704) |
| Enumeration Date | 2019-06-10 |
| Last Update Date | 2023-02-27 |