| NPI | 1962632265 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: TN 22761) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: KY 3006156) |
| 363LF0000X Nurse Practitioner, Family (Licence: KY 3006156) | |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: KY 2019053838) | |
| Enumeration Date | 2009-07-21 |
| Last Update Date | 2024-09-13 |