| NPI | 1942979810 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: KY 3016666) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: KY 3016666) |
| Enumeration Date | 2021-09-13 |
| Last Update Date | 2024-06-04 |