| NPI | 1730112137 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207QA0401X Family Medicine, Addiction Medicine (Licence: OH 35.135164) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: WV 21522) |
| Enumeration Date | 2006-07-09 |
| Last Update Date | 2020-11-19 |