| NPI | 1770553463 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: KY 27472) |
| Additional Taxonomies | 2083A0300X Preventive Medicine, Addiction Medicine (Licence: KY 27472) |
| Enumeration Date | 2006-01-25 |
| Last Update Date | 2023-03-07 |