| NPI | 1962102988 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KY 4052785) |
| Additional Taxonomies | 163WP0808X Registered Nurse, Psych/Mental Health (Licence: KY 485539) |
| Enumeration Date | 2023-03-08 |
| Last Update Date | 2026-04-03 |