| NPI | 1366698755 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TN 0000015841) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: AR c6492) |
| 207QA0401X Family Medicine, Addiction Medicine (Licence: PA MD446896) | |
| Enumeration Date | 2008-08-18 |
| Last Update Date | 2019-09-26 |