| NPI | 1710456561 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: WV 2209) |
| Additional Taxonomies | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: WV 2209) |
| Enumeration Date | 2018-11-21 |
| Last Update Date | 2025-07-14 |