| NPI | 1144457656 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207QA0401X Family Medicine, Addiction Medicine (Licence: MA 291552) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NY 266695) |
| 207Q00000X Family Medicine (Licence: NH 17778) | |
| Enumeration Date | 2009-06-11 |
| Last Update Date | 2023-11-17 |