| NPI | 1376809111 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2083A0300X Preventive Medicine, Addiction Medicine (Licence: NC 2015-01569) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NC 2015-01569) |
| Enumeration Date | 2012-04-05 |
| Last Update Date | 2025-02-04 |