| NPI | 1639271190 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207QG0300X Family Medicine, Geriatric Medicine (Licence: FL ME89320) |
| Additional Taxonomies | 207QG0300X Family Medicine, Geriatric Medicine (Licence: TN 15824) |
| Enumeration Date | 2006-09-03 |
| Last Update Date | 2007-07-17 |