| NPI | 1528083813 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: KY 3004412) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: WV 57317) |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: KY 3004412) | |
| Enumeration Date | 2006-07-13 |
| Last Update Date | 2022-04-19 |