| NPI | 1902800600 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: KS 53-75415-021) |
| Additional Taxonomies | 163WG0000X Registered Nurse, General Practice (Licence: MO 06917) |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MO C5002565) | |
| Enumeration Date | 2005-06-09 |
| Last Update Date | 2022-03-28 |