NPI | 1730624198 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: WV 84954) |
Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: WV APRN84954-AGPCNP-BC) |
Enumeration Date | 2016-12-21 |
Last Update Date | 2020-06-19 |