| NPI | 1972745156 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: WV 50676) |
| Additional Taxonomies | 207QA0401X Family Medicine, Addiction Medicine (Licence: WV 50676) |
| 363LF0000X Nurse Practitioner, Family (Licence: WV 50676) | |
| Enumeration Date | 2009-04-02 |
| Last Update Date | 2020-11-18 |