| NPI | 1326605890 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: SC 82518) |
| Additional Taxonomies | 2083A0300X Preventive Medicine, Addiction Medicine (Licence: SC 82518) |
| Enumeration Date | 2019-05-21 |
| Last Update Date | 2026-04-13 |