| NPI | 1023068780 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084A0401X Psychiatry & Neurology, Addiction Medicine (Licence: OR MD150515) |
| Additional Taxonomies | 2084A0401X Psychiatry & Neurology, Addiction Medicine (Licence: WA MD 39129) |
| Enumeration Date | 2006-05-11 |
| Last Update Date | 2015-11-01 |