| NPI | 1568976413 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207QA0401X Family Medicine Addiction Medicine (Licence: LA AP09279) |
| Additional Taxonomies | 208D00000X General Practice (Licence: LA 452815734) |
| 363LP0808X Nurse Practitioner Psychiatric/Mental Health (Licence: LA AP09279) | |
| Enumeration Date | 2017-11-29 |
| Last Update Date | 2025-05-27 |