| NPI | 1114337508 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207QG0300X Family Medicine, Geriatric Medicine (Licence: PA OS019037) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: PA OT015771) |
| Enumeration Date | 2014-05-06 |
| Last Update Date | 2018-07-09 |