| NPI | 1376544874 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084A0401X Psychiatry & Neurology, Addiction Medicine (Licence: CA G145852) |
| Additional Taxonomies | 2084A0401X Psychiatry & Neurology, Addiction Medicine (Licence: UT 188338-1205) |
| 2084A0401X Psychiatry & Neurology, Addiction Medicine (Licence: WI 29118-20) | |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: WI 29118-20) | |
| Enumeration Date | 2005-08-09 |
| Last Update Date | 2024-11-05 |