| NPI | 1144870155 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: WV 103044) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: PA SP020770P) |
| 363LF0000X Nurse Practitioner, Family (Licence: MD R189448) | |
| Enumeration Date | 2019-09-12 |
| Last Update Date | 2024-10-23 |