| NPI | 1659710390 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207QA0401X Family Medicine, Addiction Medicine (Licence: MN 61169) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MN 61169) |
| Enumeration Date | 2013-06-16 |
| Last Update Date | 2025-04-25 |