| NPI | 1275521809 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NC 200100315) |
| Additional Taxonomies | 2084A0401X Psychiatry & Neurology, Addiction Medicine (Licence: NC 2001-00315) |
| Enumeration Date | 2005-10-07 |
| Last Update Date | 2017-06-30 |