| 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 |