| NPI | 1063867398 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2083A0300X Preventive Medicine, Addiction Medicine (Licence: OH 35.150986) |
| Additional Taxonomies | 208D00000X General Practice (Licence: PA MD469499) |
| Enumeration Date | 2016-04-23 |
| Last Update Date | 2024-08-04 |