| NPI | 1609862010 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NC 9601191) |
| Additional Taxonomies | 207QG0300X Family Medicine Geriatric Medicine (Licence: NC 9601191) |
| Enumeration Date | 2005-09-21 |
| Last Update Date | 2016-12-07 |