| NPI | 1063730190 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MI 4301104638) |
| Additional Taxonomies | 207RA0401X Internal Medicine, Addiction Medicine (Licence: MI 4301104638) |
| Enumeration Date | 2010-05-13 |
| Last Update Date | 2017-01-05 |