| NPI | 1811994700 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TN 63783) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: VA 0101233837) |
| 207QA0401X Family Medicine, Addiction Medicine (Licence: TN 63783) | |
| Enumeration Date | 2005-07-07 |
| Last Update Date | 2023-05-03 |