| NPI | 1295306488 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MS 904359) |
| Additional Taxonomies | 324500000X Substance Abuse Rehabilitation Facility (Licence: TX 1049367) |
| 207Q00000X Family Medicine (Licence: TX 1049367) | |
| Enumeration Date | 2021-07-08 |
| Last Update Date | 2022-12-02 |