| NPI | 1669796546 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207QA0401X Family Medicine, Addiction Medicine (Licence: MI 5101027992) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NH 15470) |
| Enumeration Date | 2010-03-20 |
| Last Update Date | 2025-06-26 |