| NPI | 1972730687 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207QA0401X Family Medicine Addiction Medicine (Licence: MN 52552) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MN 52552) |
| Enumeration Date | 2009-06-19 |
| Last Update Date | 2022-12-05 |