| NPI | 1053975722 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207QA0401X Family Medicine, Addiction Medicine (Licence: IL 336.123413) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IL 336.123413) |
| Enumeration Date | 2019-04-27 |
| Last Update Date | 2023-10-24 |