| NPI | 1235511742 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207QA0401X Family Medicine, Addiction Medicine (Licence: SC 38342) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: SC 38342) |
| 207Q00000X Family Medicine (Licence: GA 80885) | |
| Enumeration Date | 2015-06-19 |
| Last Update Date | 2021-05-06 |