| NPI | 1609281567 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207QG0300X Family Medicine, Geriatric Medicine (Licence: WI 69714) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: ME TP14078) |
| Enumeration Date | 2014-06-30 |
| Last Update Date | 2024-07-16 |