| NPI | 1083874226 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NY 248946-1) |
| Additional Taxonomies | 207QA0401X Family Medicine Addiction Medicine (Licence: NY 248946-1) |
| Enumeration Date | 2008-06-11 |
| Last Update Date | 2019-09-27 |