| NPI | 1700047016 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MI 4301500556) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: WA MD60257660) |
| 207QA0401X Family Medicine, Addiction Medicine (Licence: IL 036136479) | |
| 207Q00000X Family Medicine (Licence: NY 249068) | |
| Enumeration Date | 2008-06-19 |
| Last Update Date | 2026-03-24 |