| NPI | 1124374004 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NM CNP02306) |
| Additional Taxonomies | 207QA0401X Family Medicine, Addiction Medicine (Licence: NM CNP02306) |
| Enumeration Date | 2012-07-30 |
| Last Update Date | 2019-08-19 |