| NPI | 1164956397 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: KY 52880) |
| Additional Taxonomies | 2084A0401X Psychiatry & Neurology, Addiction Medicine (Licence: KY 52880) |
| 2083A0300X Preventive Medicine, Addiction Medicine (Licence: KY 52880) | |
| Enumeration Date | 2017-04-14 |
| Last Update Date | 2021-06-28 |