| NPI | 1609811033 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MD C0001948) |
| Additional Taxonomies | 207RA0401X Internal Medicine Addiction Medicine (Licence: MD C0001948) |
| 207R00000X Internal Medicine (Licence: MD C0001948) | |
| Enumeration Date | 2006-06-19 |
| Last Update Date | 2014-01-03 |