| NPI | 1104146620 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207QG0300X Family Medicine, Geriatric Medicine (Licence: WA MD60556212) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: WA MD60556212) |
| Enumeration Date | 2010-06-07 |
| Last Update Date | 2021-05-19 |