| NPI | 1184166852 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: CA 95017890) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: CA 635164) |
| 163WA0400X Registered Nurse, Addiction (Substance Use Disorder) (Licence: CA 635164) | |
| Enumeration Date | 2016-11-13 |
| Last Update Date | 2022-08-01 |