| NPI | 1508429143 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208VP0000X (Licence: CA A176795) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CA A176795) |
| 2083A0300X Preventive Medicine, Addiction Medicine (Licence: CA A176795) | |
| Enumeration Date | 2019-04-18 |
| Last Update Date | 2025-03-11 |