NPI | 1013412386 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207QA0401X Family Medicine, Addiction Medicine (Licence: NJ 25MA11921500) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: WA MD61055643) |
Enumeration Date | 2018-03-28 |
Last Update Date | 2023-10-11 |