| NPI | 1124378864 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: SC 36907) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: FL ME114027) |
| 207QG0300X Family Medicine, Geriatric Medicine (Licence: VA 0116025456) | |
| Enumeration Date | 2012-09-10 |
| Last Update Date | 2021-12-17 |