| NPI | 1609532233 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: WV 110573) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: WV 56975) |
| 363LF0000X Nurse Practitioner, Family (Licence: WV 110572) | |
| Enumeration Date | 2021-11-09 |
| Last Update Date | 2023-12-06 |