NPI | 1457640435 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207QA0401X Family Medicine, Addiction Medicine (Licence: NY 283914) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: VT 042.0012920) |
390200000X Student in an Organized Health Care Education/Training Program (Licence: OH 35.125963) | |
Enumeration Date | 2011-03-30 |
Last Update Date | 2016-07-15 |