| NPI | 1356621486 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: MI 5101028235) |
| Additional Taxonomies | 163WA0400X Registered Nurse, Addiction (Substance Use Disorder) (Licence: MI 4704267821) |
| Enumeration Date | 2011-08-21 |
| Last Update Date | 2025-03-03 |