| NPI | 1306299920 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207QG0300X Family Medicine Geriatric Medicine (Licence: WA OP61076678) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: PA OT017245) |
| Enumeration Date | 2016-07-19 |
| Last Update Date | 2020-09-22 |