| NPI | 1063421030 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: KY 36635) |
| Additional Taxonomies | 103TA0400X Psychologist, Addiction (Substance Use Disorder) (Licence: KY 36635) |
| Enumeration Date | 2006-08-07 |
| Last Update Date | 2020-03-11 |