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 |