| NPI | 1619557485 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: PA OT020515) |
| Additional Taxonomies | 207QA0401X Family Medicine, Addiction Medicine (Licence: PA OT020515) |
| Enumeration Date | 2021-04-14 |
| Last Update Date | 2024-11-30 |