| NPI | 1114112604 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: VA 0024174109) |
| Additional Taxonomies | 163WA0400X Registered Nurse, Addiction (Substance Use Disorder) (Licence: VA 0001191728) |
| 363LA2200X Nurse Practitioner, Adult Health (Licence: VA 0024174109) | |
| Enumeration Date | 2007-09-08 |
| Last Update Date | 2023-01-15 |