| NPI | 1164193702 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: VA 0024182739) |
| Additional Taxonomies | 207QA0401X Family Medicine Addiction Medicine (Licence: VA 0024182739) |
| Enumeration Date | 2021-09-23 |
| Last Update Date | 2024-05-14 |