| NPI | 1457508079 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207QG0300X Family Medicine, Geriatric Medicine (Licence: MA 271152) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NC 2013-00450) |
| 207Q00000X Family Medicine (Licence: IA R-8277) | |
| Enumeration Date | 2008-08-26 |
| Last Update Date | 2022-07-21 |