| NPI | 1124483235 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: WV 123790) |
| Additional Taxonomies | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: VT 101.0136813) |
| 363LA2200X Nurse Practitioner, Adult Health (Licence: VT 101.0136813) | |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: WV 123790) | |
| Enumeration Date | 2015-12-17 |
| Last Update Date | 2025-08-19 |