| NPI | 1366562662 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207QA0401X Family Medicine, Addiction Medicine (Licence: MN 65016) |
| Additional Taxonomies | 207QA0401X Family Medicine, Addiction Medicine (Licence: IN 01030450A) |
| Enumeration Date | 2007-03-30 |
| Last Update Date | 2021-03-12 |