NPI | 1912153115 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL ME143957) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: TX R9026) |
207QA0401X Family Medicine, Addiction Medicine (Licence: FL ME143957) | |
Enumeration Date | 2008-08-07 |
Last Update Date | 2023-11-01 |