| NPI | 1629068705 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: WV 106941) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: WV 33849) |
| Enumeration Date | 2005-10-28 |
| Last Update Date | 2024-07-23 |