| NPI | 1902447568 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner Psychiatric/Mental Health (Licence: KY 2022065354) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: KY F12180735) |
| Enumeration Date | 2019-10-04 |
| Last Update Date | 2023-06-30 |