| NPI | 1407286503 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207QA0401X Family Medicine, Addiction Medicine (Licence: WA OP60560271) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: WA OP60560271) |
| 207QA0401X Family Medicine, Addiction Medicine (Licence: CA 13046) | |
| Enumeration Date | 2013-11-26 |
| Last Update Date | 2026-07-07 |