| NPI | 1942656244 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207QA0401X Family Medicine Addiction Medicine (Licence: OH LICDC-CS 933508) |
| Additional Taxonomies | 207QA0401X Family Medicine Addiction Medicine (Licence: OH LSW S0021857) |
| Enumeration Date | 2016-05-05 |
| Last Update Date | 2016-05-05 |