| NPI | 1710574587 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 163W00000X Registered Nurse (Licence: MS 001037) |
| Additional Taxonomies | 163WA0400X Registered Nurse, Addiction (Substance Use Disorder) (Licence: MS 001037) |
| 163WA2000X Registered Nurse, Administrator (Licence: MS 001037) | |
| Enumeration Date | 2020-12-28 |
| Last Update Date | 2020-12-28 |