| NPI | 1053802843 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CA A181162) |
| Additional Taxonomies | 207RA0401X Internal Medicine, Addiction Medicine (Licence: CA A181162) |
| 207R00000X Internal Medicine (Licence: NY 302421) | |
| Enumeration Date | 2018-05-29 |
| Last Update Date | 2025-11-03 |