| NPI | 1104893817 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: AL MD.38543) |
| Additional Taxonomies | 207QA0401X Family Medicine, Addiction Medicine (Licence: AL 38543) |
| Enumeration Date | 2006-03-01 |
| Last Update Date | 2023-02-14 |