| NPI | 1639213366 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 174400000X Specialist (Licence: MO 35725) |
| Additional Taxonomies | 207RA0401X Internal Medicine Addiction Medicine (Licence: IL 036-058285) |
| Enumeration Date | 2007-02-16 |
| Last Update Date | 2015-10-09 |