| NPI | 1619138351 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: OR MD190889) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: AZ 43057) |
| 207QG0300X Family Medicine Geriatric Medicine (Licence: AZ 43057) | |
| Enumeration Date | 2008-06-24 |
| Last Update Date | 2019-03-20 |