| NPI | 1174500169 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207QG0300X Family Medicine, Geriatric Medicine (Licence: FL ME129197) |
| Additional Taxonomies | 174400000X Specialist (Licence: PR 13442) |
| Enumeration Date | 2005-12-29 |
| Last Update Date | 2019-08-20 |