| NPI | 1609827260 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207QG0300X Family Medicine Geriatric Medicine (Licence: KY 37637) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: KY 37637) |
| Enumeration Date | 2006-05-16 |
| Last Update Date | 2013-03-22 |