| NPI | 1053801894 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084A0401X Psychiatry & Neurology, Addiction Medicine (Licence: MT NURAPRNLIC130501) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MT 130501) |
| Enumeration Date | 2018-05-17 |
| Last Update Date | 2023-12-05 |