| NPI | 1952033698 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: AZ 68989) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NY 314344) |
| 207QA0401X Family Medicine, Addiction Medicine (Licence: AZ 68989) | |
| Enumeration Date | 2022-06-30 |
| Last Update Date | 2024-01-17 |