| NPI | 1285769158 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208D00000X General Practice (Licence: NC 2019-02545) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CO 27763) |
| 207QA0401X Family Medicine Addiction Medicine (Licence: NC 2019-02545) | |
| Enumeration Date | 2007-02-22 |
| Last Update Date | 2022-11-10 |