| NPI | 1942573522 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: WV APRN88151) |
| Additional Taxonomies | 363LA2100X Nurse Practitioner Acute Care (Licence: MI 4704232812) |
| 363LP0808X Nurse Practitioner Psychiatric/Mental Health (Licence: WV APRN88151) | |
| Enumeration Date | 2012-02-13 |
| Last Update Date | 2022-06-30 |