| NPI | 1467897058 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208D00000X General Practice (Licence: NY 231868) |
| Additional Taxonomies | 207RA0401X Internal Medicine, Addiction Medicine (Licence: NY 231868) |
| Enumeration Date | 2013-05-08 |
| Last Update Date | 2019-04-03 |