| NPI | 1184486573 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner Psychiatric/Mental Health (Licence: WV 2023207452) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: WV 106251) |
| Enumeration Date | 2024-01-30 |
| Last Update Date | 2024-05-06 |