| NPI | 1124446430 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084A0401X Psychiatry & Neurology, Addiction Medicine (Licence: NC 2016-00667) |
| Additional Taxonomies | 208D00000X General Practice (Licence: NC 2016-00667) |
| Enumeration Date | 2014-04-03 |
| Last Update Date | 2020-06-18 |