| NPI | 1679535991 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207QG0300X Family Medicine, Geriatric Medicine (Licence: ND 15917) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MN 45735) |
| 207QG0300X Family Medicine, Geriatric Medicine (Licence: MN 45749) | |
| Enumeration Date | 2006-04-03 |
| Last Update Date | 2021-10-20 |