| NPI | 1023668092 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084A0401X Psychiatry & Neurology, Addiction Medicine (Licence: FL 2021031024) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: FL 11002262) |
| Enumeration Date | 2019-09-12 |
| Last Update Date | 2021-09-14 |