| NPI | 1558416677 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: KY 02855) |
| Additional Taxonomies | 103TA0400X Psychologist, Addiction (Substance Use Disorder) (Licence: KY 02855) |
| Enumeration Date | 2007-01-25 |
| Last Update Date | 2020-02-20 |