| NPI | 1215913728 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207QG0300X Family Medicine Geriatric Medicine (Licence: FL ME125594) |
| Additional Taxonomies | 207QG0300X Family Medicine Geriatric Medicine (Licence: OH 35084673) |
| Enumeration Date | 2005-12-16 |
| Last Update Date | 2025-04-18 |