| NPI | 1962039289 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207QA0401X Family Medicine, Addiction Medicine (Licence: NY 330293) |
| Additional Taxonomies | 207QA0401X Family Medicine, Addiction Medicine (Licence: CA A180675) |
| Enumeration Date | 2020-03-25 |
| Last Update Date | 2024-08-18 |