| NPI | 1174716690 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207QA0505X Family Medicine, Adult Medicine (Licence: NY 192537-1) |
| Additional Taxonomies | 207QA0401X Family Medicine, Addiction Medicine (Licence: NY 192537-1) |
| Enumeration Date | 2007-08-20 |
| Last Update Date | 2007-08-20 |