| NPI | 1336432103 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207QG0300X Family Medicine, Geriatric Medicine (Licence: WA OP60546764) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: PA OT014300) |
| Enumeration Date | 2011-05-26 |
| Last Update Date | 2021-11-26 |