NPI | 1275969990 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 261QM2800X Clinic/Center, Methadone Clinic (Licence: MI 580077) |
Additional Taxonomies | 261QM2800X Clinic/Center, Methadone Clinic (Licence: MI 823074) |
Enumeration Date | 2013-09-26 |
Last Update Date | 2013-09-26 |