| NPI | 1306452800 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: WV 106586) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: VA 0024179403) |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: VA 0024179403) | |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: WV 106586) | |
| Enumeration Date | 2020-09-20 |
| Last Update Date | 2023-01-24 |