| NPI | 1588641880 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207QA0401X Family Medicine, Addiction Medicine (Licence: NC 200101342) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NC 200101342) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NC 200101342) | |
| Enumeration Date | 2005-12-28 |
| Last Update Date | 2022-11-15 |