| NPI | 1194165605 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA A153610) |
| Additional Taxonomies | 261QP2400X Clinic/Center, Prison Health (Licence: CA A153610) |
| 207QA0401X Family Medicine, Addiction Medicine (Licence: CA A153610) | |
| 208D00000X General Practice (Licence: CA A153610) | |
| Enumeration Date | 2013-06-28 |
| Last Update Date | 2026-03-07 |