| 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 |