| NPI | 1770213100 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207QG0300X Family Medicine, Geriatric Medicine (Licence: MD D0102787) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: VA 0101279963) |
| Enumeration Date | 2022-06-17 |
| Last Update Date | 2026-01-17 |