| NPI | 1740505270 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207QG0300X Family Medicine, Geriatric Medicine (Licence: MI 4301096624)  | 
| Additional Taxonomies | 207QG0300X Family Medicine, Geriatric Medicine (Licence: OH 35.124974)  | 
| Enumeration Date | 2010-03-26 | 
| Last Update Date | 2021-03-17 |