| NPI | 1164590535 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: PA MD417197) |
| Additional Taxonomies | 207QA0401X Family Medicine, Addiction Medicine (Licence: PA MD417197) |
| Enumeration Date | 2006-12-01 |
| Last Update Date | 2007-07-08 |