| NPI | 1962283903 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: KS 5382666101) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: KS 53-82666-101) |
| Enumeration Date | 2023-10-06 |
| Last Update Date | 2026-03-30 |