NPI | 1497046072 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207QA0401X Family Medicine, Addiction Medicine (Licence: ME MD25329) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: NY 277151) |
Enumeration Date | 2011-04-29 |
Last Update Date | 2022-12-21 |