| NPI | 1215128202 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207QG0300X Family Medicine, Geriatric Medicine (Licence: CT 056905) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NC 2009-01180) |
| 208D00000X General Practice (Licence: NC 2009-01180) | |
| Enumeration Date | 2007-08-06 |
| Last Update Date | 2022-07-11 |