| NPI | 1871542290 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: FL APRN9470404) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: KY 3003878) |
| 363LF0000X Nurse Practitioner, Family (Licence: KY 3003878) | |
| Enumeration Date | 2006-05-10 |
| Last Update Date | 2022-04-22 |