| NPI | 1972777902 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NC 2012-00652) |
| Additional Taxonomies | 2084P0802X Psychiatry & Neurology, Addiction Psychiatry (Licence: NC 178740) |
| Enumeration Date | 2008-04-22 |
| Last Update Date | 2016-09-29 |