| NPI | 1992163653 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: TN APN0000020472) |
| Additional Taxonomies | 163WA0400X Registered Nurse Addiction (Substance Use Disorder) (Licence: TN 20472) |
| Enumeration Date | 2016-02-09 |
| Last Update Date | 2021-10-06 |