| NPI | 1225739089 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207QG0300X Family Medicine, Geriatric Medicine (Licence: MO AG03230012)  | 
| Additional Taxonomies | 207QA0505X Family Medicine, Adult Medicine (Licence: MO AG03230012)  | 
| Enumeration Date | 2023-03-16 | 
| Last Update Date | 2023-03-16 |