| NPI | 1790892982 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MT 9835) |
| Additional Taxonomies | 207QG0300X Family Medicine, Geriatric Medicine (Licence: NM MD2012-0719) |
| Enumeration Date | 2006-08-24 |
| Last Update Date | 2013-04-24 |