| NPI | 1609821867 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WI 34553-20) |
| Additional Taxonomies | 2084A0401X Psychiatry & Neurology, Addiction Medicine (Licence: WI 34553-20) |
| Enumeration Date | 2006-05-24 |
| Last Update Date | 2022-04-15 |