| NPI | 1104313253 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 163W00000X Registered Nurse (Licence: WI 224953-30) |
| Additional Taxonomies | 163WA0400X Registered Nurse, Addiction (Substance Use Disorder) (Licence: WI 224953-30) |
| Enumeration Date | 2018-04-15 |
| Last Update Date | 2018-06-01 |