| NPI | 1548536550 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 163W00000X Registered Nurse (Licence: MA RN251756) |
| Additional Taxonomies | 163WA0400X Registered Nurse Addiction (Substance Use Disorder) (Licence: MA RN251756) |
| Enumeration Date | 2012-03-24 |
| Last Update Date | 2012-03-24 |