| NPI | 1386173698 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LA0401X Anesthesiology Addiction Medicine (Licence: CA A87500) |
| Additional Taxonomies | 208D00000X General Practice (Licence: FL TPME766) |
| Enumeration Date | 2017-06-08 |
| Last Update Date | 2025-07-23 |