NPI | 1235607524 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP0808X Nurse Practitioner Psychiatric/Mental Health (Licence: WV 84554) |
Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: WV APRN84554NP) |
Enumeration Date | 2018-11-05 |
Last Update Date | 2024-10-25 |