| 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 |