| NPI | 1104350529 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207QA0401X Family Medicine, Addiction Medicine (Licence: PA MD480630) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: WI 70237) |
| 207Q00000X Family Medicine (Licence: PA MD480630) | |
| Enumeration Date | 2017-04-12 |
| Last Update Date | 2024-04-02 |