| NPI | 1073753497 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207QA0401X Family Medicine Addiction Medicine (Licence: MD D0076796) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NC 2011-01420) |
| Enumeration Date | 2009-02-25 |
| Last Update Date | 2022-04-27 |