| NPI | 1770730566 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163W00000X Registered Nurse (Licence: ND R16206) |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: ND 1276) |
| Enumeration Date | 2008-08-22 |
| Last Update Date | 2008-08-22 |