NPI | 1336405711 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207QA0401X Family Medicine Addiction Medicine (Licence: LA MD206792) |
Additional Taxonomies | 2083A0300X Preventive Medicine Addiction Medicine (Licence: VA 0101270381) |
103TA0400X Psychologist Addiction (Substance Use Disorder) | |
207Q00000X Family Medicine (Licence: VA 0101270381) | |
207Q00000X Family Medicine (Licence: LA MD.206792) | |
Enumeration Date | 2012-04-10 |
Last Update Date | 2024-10-10 |