| NPI | 1073508966 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207QG0300X Family Medicine, Geriatric Medicine (Licence: CO 45066) |
| Additional Taxonomies | 207QG0300X Family Medicine, Geriatric Medicine (Licence: AZ 34599) |
| Enumeration Date | 2005-09-16 |
| Last Update Date | 2016-10-10 |