| NPI | 1801150800 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207QA0401X Family Medicine, Addiction Medicine (Licence: CA 20A14705) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: FL OS13424) |
| 207Q00000X Family Medicine (Licence: PA OT014535) | |
| Enumeration Date | 2012-06-25 |
| Last Update Date | 2021-12-07 |