| NPI | 1982646998 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: KY 3003911) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: KY 3911P) |
| 103T00000X Psychologist (Licence: KY 130764) | |
| Enumeration Date | 2006-06-12 |
| Last Update Date | 2016-12-14 |