| NPI | 1821610254 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2083A0300X Preventive Medicine, Addiction Medicine (Licence: NY 324670) |
| Additional Taxonomies | 208D00000X General Practice (Licence: NY 324670) |
| Enumeration Date | 2020-05-07 |
| Last Update Date | 2024-11-08 |