| NPI | 1760061626 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MO 2024049440) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: KS 05-51621) |
| 207QG0300X Family Medicine, Geriatric Medicine (Licence: MO 2024049440) | |
| 207QG0300X Family Medicine, Geriatric Medicine (Licence: KS 05-51621) | |
| Enumeration Date | 2021-04-06 |
| Last Update Date | 2025-08-19 |