| NPI | 1194080143 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: GA 05726) |
| Additional Taxonomies | 207QG0300X Family Medicine, Geriatric Medicine (Licence: AL 1509) |
| 207QG0300X Family Medicine, Geriatric Medicine (Licence: GA 076448) | |
| Enumeration Date | 2012-07-05 |
| Last Update Date | 2016-09-20 |