| NPI | 1033565395 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084A0401X Psychiatry & Neurology, Addiction Medicine (Licence: AZ 76066) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CA A150575) |
| Enumeration Date | 2016-05-05 |
| Last Update Date | 2025-07-16 |