| NPI | 1548553423 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LA2200X Nurse Practitioner Adult Health (Licence: TN 15380) |
| Additional Taxonomies | 163WA0400X Registered Nurse Addiction (Substance Use Disorder) (Licence: TN 15380) |
| Enumeration Date | 2011-05-25 |
| Last Update Date | 2011-06-09 |