| NPI | 1073833703 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: ME md20614) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MO 2013027609) |
| 2083A0300X Preventive Medicine, Addiction Medicine (Licence: ME MD20614) | |
| Enumeration Date | 2010-06-04 |
| Last Update Date | 2022-09-30 |