| NPI | 1508818790 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207QA0401X Family Medicine Addiction Medicine (Licence: VA 0024165247) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: VA 0024165247) |
| Enumeration Date | 2006-05-16 |
| Last Update Date | 2021-11-18 |