| NPI | 1215990049 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WV 13962) |
| Additional Taxonomies | 207QG0300X Family Medicine, Geriatric Medicine (Licence: WV 13962) |
| Enumeration Date | 2006-04-11 |
| Last Update Date | 2007-07-08 |