| NPI | 1477820173 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: LA AP10123) |
| Additional Taxonomies | 163WA0400X Registered Nurse, Addiction (Substance Use Disorder) (Licence: VA 0001233148) |
| 363LP0200X Nurse Practitioner, Pediatrics (Licence: PA SP009725) | |
| Enumeration Date | 2011-11-23 |
| Last Update Date | 2022-04-18 |