NPI | 1053302604 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207QA0401X Family Medicine, Addiction Medicine (Licence: ME EC251084) |
Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: NH 22896) |
Enumeration Date | 2005-11-02 |
Last Update Date | 2025-08-06 |