NPI | 1871194563 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: AZ 221957) |
363LF0000X Nurse Practitioner, Family (Licence: SC 27884) | |
Enumeration Date | 2020-11-08 |
Last Update Date | 2024-05-06 |