| NPI | 1568802965 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207QG0300X Family Medicine, Geriatric Medicine (Licence: PA OS018296) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA OT015462) |
| Enumeration Date | 2013-06-28 |
| Last Update Date | 2016-09-15 |