NPI | 1801365101 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MD R193445) |
Additional Taxonomies | 207QA0401X Family Medicine, Addiction Medicine (Licence: MD R193445) |
Enumeration Date | 2018-11-15 |
Last Update Date | 2025-05-10 |