| NPI | 1063623817 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL ME99923) |
| Additional Taxonomies | 207QG0300X Family Medicine, Geriatric Medicine (Licence: FL 99923) |
| 207QG0300X Family Medicine, Geriatric Medicine (Licence: NY 251889) | |
| Enumeration Date | 2007-05-24 |
| Last Update Date | 2026-01-22 |