| 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 |