| NPI | 1255596052 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL ME108611) |
| Additional Taxonomies | 207QA0505X Family Medicine, Adult Medicine (Licence: FL ME108611) |
| 207QG0300X Family Medicine, Geriatric Medicine (Licence: FL ME108611) | |
| Enumeration Date | 2008-07-22 |
| Last Update Date | 2025-08-14 |