| NPI | 1982627352 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2083A0300X Preventive Medicine, Addiction Medicine (Licence: FL ME78176) |
| Additional Taxonomies | 251S00000X Community/Behavioral Health (Licence: FL ME78176) |
| 207P00000X Emergency Medicine (Licence: FL ME78176) | |
| Enumeration Date | 2006-07-25 |
| Last Update Date | 2024-03-20 |