| NPI | 1770746554 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207QG0300X Family Medicine, Geriatric Medicine (Licence: AZ 55748) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: TX P3193) |
| Enumeration Date | 2008-07-02 |
| Last Update Date | 2018-06-13 |