| NPI | 1063473551 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207QG0300X Family Medicine, Geriatric Medicine (Licence: MD D61785) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: WV 22045) |
| Enumeration Date | 2006-04-01 |
| Last Update Date | 2022-04-21 |