| NPI | 1619499597 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207QG0300X Family Medicine Geriatric Medicine (Licence: FL ME155734) |
| Additional Taxonomies | 208D00000X General Practice (Licence: PR 33029-R) |
| 207Q00000X Family Medicine (Licence: PR 21708) | |
| Enumeration Date | 2017-07-12 |
| Last Update Date | 2024-01-19 |