| NPI | 1902426422 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084A0401X Psychiatry & Neurology, Addiction Medicine (Licence: NY 329772) |
| Additional Taxonomies | 208D00000X General Practice (Licence: VA 0101274317) |
| Enumeration Date | 2020-04-24 |
| Last Update Date | 2024-10-15 |