| NPI | 1528035805 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NY 194368) |
| Additional Taxonomies | 207QA0401X Family Medicine, Addiction Medicine (Licence: NY 194368) |
| Enumeration Date | 2006-03-04 |
| Last Update Date | 2019-12-28 |