| NPI | 1699062257 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RA0401X Internal Medicine Addiction Medicine (Licence: OH 35.128078) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OH 35.128078) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2011-07-05 |
| Last Update Date | 2023-01-09 |