| NPI | 1063807329 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207QA0401X Family Medicine, Addiction Medicine (Licence: PA OS019001) |
| Additional Taxonomies | 207QA0401X Family Medicine, Addiction Medicine (Licence: NJ 25MB10441900) |
| Enumeration Date | 2015-04-03 |
| Last Update Date | 2023-05-18 |