| NPI | 1578613030 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: KY 49101) |
| Additional Taxonomies | 207QA0401X Family Medicine, Addiction Medicine (Licence: KY 49101) |
| Enumeration Date | 2007-01-10 |
| Last Update Date | 2023-08-17 |