| NPI | 1013172121 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: OH 34011290) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: PA OS014900) |
| 207QG0300X Family Medicine Geriatric Medicine (Licence: PA OS014900) | |
| Enumeration Date | 2008-07-29 |
| Last Update Date | 2016-08-16 |