| NPI | 1396214276 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: SC 22303) |
| Additional Taxonomies | 324500000X Substance Abuse Rehabilitation Facility (Licence: SC 22303) |
| Enumeration Date | 2018-11-20 |
| Last Update Date | 2026-01-11 |