| NPI | 1467924480 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NC 5011355)  | 
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NC 196513)  | 
| 207Q00000X Family Medicine (Licence: NC GRAN-SM8XV8)  | |
| 207QG0300X Family Medicine, Geriatric Medicine (Licence: NC GRAN-SM8XV8)  | |
| Enumeration Date | 2019-01-02 | 
| Last Update Date | 2023-07-27 |