NPI | 1780914515 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 163WA0400X Registered Nurse, Addiction (Substance Use Disorder) (Licence: KY 1141759) |
Additional Taxonomies | 164W00000X Licensed Practical Nurse (Licence: IN 27062998A) |
Enumeration Date | 2009-12-29 |
Last Update Date | 2016-01-05 |