| NPI | 1710186705 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207QG0300X Family Medicine Geriatric Medicine (Licence: TX P0908) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: WI 56082-20) |
| Enumeration Date | 2007-07-11 |
| Last Update Date | 2016-09-26 |