| NPI | 1598022204 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207QA0401X Family Medicine Addiction Medicine (Licence: VT 042-0009231) |
| Additional Taxonomies | 207QA0401X Family Medicine Addiction Medicine (Licence: MA 265685) |
| Enumeration Date | 2012-04-19 |
| Last Update Date | 2016-06-30 |