| NPI | 1982691382 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: WV 33507) |
| Additional Taxonomies | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: WV 2021101359) |
| Enumeration Date | 2005-09-30 |
| Last Update Date | 2023-06-06 |