| NPI | 1548612518 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP2300X Nurse Practitioner Primary Care (Licence: CT 005943) |
| Additional Taxonomies | 163WA0400X Registered Nurse Addiction (Substance Use Disorder) (Licence: CT 76657) |
| Enumeration Date | 2016-07-01 |
| Last Update Date | 2022-01-24 |