| NPI | 1902125776 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA A118279) |
| Additional Taxonomies | 207QA0401X Family Medicine, Addiction Medicine (Licence: CA A118279) |
| Enumeration Date | 2010-05-19 |
| Last Update Date | 2019-06-03 |