| NPI | 1316580798 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2083P0500X Preventive Medicine, Preventive Medicine/Occupational Environmental Medicine (Licence: OK 18027) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| 2083A0300X Preventive Medicine, Addiction Medicine (Licence: OK 10827) | |
| Enumeration Date | 2019-10-18 |
| Last Update Date | 2026-05-05 |