| 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 |