| NPI | 1235256694 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084A0401X Psychiatry & Neurology, Addiction Medicine (Licence: NC 19360) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NC 19360) |
| Enumeration Date | 2007-03-23 |
| Last Update Date | 2021-07-30 |