| NPI | 1962046094 |
|---|---|
| Other Name | N/A N/A |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163WA0400X Registered Nurse, Addiction (Substance Use Disorder) (Licence: MA 2334640) |
| Enumeration Date | 2019-10-31 |
| Last Update Date | 2019-10-31 |