| NPI | 1912045360 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163W00000X Registered Nurse (Licence: LA 35367) |
| Additional Taxonomies | 163WA0400X Registered Nurse, Addiction (Substance Use Disorder) (Licence: LA 3852) |
| Enumeration Date | 2007-02-01 |
| Last Update Date | 2007-07-08 |