| NPI | 1366798589 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207QG0300X Family Medicine, Geriatric Medicine (Licence: MA 265749) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MN 58191) |
| Enumeration Date | 2012-07-25 |
| Last Update Date | 2016-09-09 |