| NPI | 1700176708 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207QA0401X Family Medicine, Addiction Medicine (Licence: CO 54306) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CO 54306) |
| 2084A0401X Psychiatry & Neurology, Addiction Medicine (Licence: CO 54306) | |
| Enumeration Date | 2011-04-11 |
| Last Update Date | 2022-10-09 |