| NPI | 1700047016 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207QA0401X Family Medicine, Addiction Medicine (Licence: IL 036136479) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NY 249068) |
| 207Q00000X Family Medicine (Licence: WA MD60257660) | |
| Enumeration Date | 2008-06-19 |
| Last Update Date | 2016-08-25 |