| NPI | 1043365927 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207QA0401X Family Medicine, Addiction Medicine (Licence: MA 239893) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MA 229863) |
| Enumeration Date | 2007-01-24 |
| Last Update Date | 2020-01-30 |