| NPI | 1386624591 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207QA0401X Family Medicine Addiction Medicine (Licence: MI 4301054205) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MI 4301054205) |
| Enumeration Date | 2006-01-23 |
| Last Update Date | 2019-06-13 |