| NPI | 1477540938 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207QG0300X Family Medicine Geriatric Medicine (Licence: WV 26847) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NV 14590) |
| Enumeration Date | 2005-09-30 |
| Last Update Date | 2021-01-08 |