| NPI | 1316966815 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207QA0401X Family Medicine Addiction Medicine (Licence: CA G64542) |
| Additional Taxonomies | 208D00000X General Practice (Licence: CA G64542) |
| Enumeration Date | 2006-07-18 |
| Last Update Date | 2015-01-13 |