| NPI | 1912954595 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RA0401X Internal Medicine Addiction Medicine (Licence: SC 29105) |
| Additional Taxonomies | 208600000X Surgery (Licence: SC 29105) |
| Enumeration Date | 2006-05-28 |
| Last Update Date | 2019-01-15 |