| NPI | 1932711652 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MI 4704189461) |
| Additional Taxonomies | 163WA0400X Registered Nurse, Addiction (Substance Use Disorder) (Licence: MI 4704189461) |
| Enumeration Date | 2020-08-24 |
| Last Update Date | 2024-03-21 |