| NPI | 1497061386 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 207QG0300X Family Medicine, Geriatric Medicine (Licence: AZ 47730) | 
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CA A113695) | 
| Enumeration Date | 2010-08-30 | 
| Last Update Date | 2022-07-21 |