| NPI | 1699813212 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KY 3003542) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: KY 1264) |
| 207RA0401X Internal Medicine, Addiction Medicine (Licence: KY 3003542) | |
| Enumeration Date | 2007-02-03 |
| Last Update Date | 2019-06-28 |