| NPI | 1922648153 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084A0401X Psychiatry & Neurology, Addiction Medicine (Licence: MT APRN157413) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MT 157413) |
| Enumeration Date | 2020-01-15 |
| Last Update Date | 2023-02-28 |