NPI | 1962653543 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207RA0401X Internal Medicine, Addiction Medicine (Licence: NH 17990) |
Additional Taxonomies | 2083A0300X Preventive Medicine, Addiction Medicine (Licence: VT 0013793) |
2083P0901X Preventive Medicine, Public Health & General Preventive Medicine (Licence: NY 208877-1) | |
Enumeration Date | 2008-10-01 |
Last Update Date | 2020-06-17 |