| NPI | 1801048202 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207QG0300X Family Medicine, Geriatric Medicine (Licence: SC 36736) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: PA OT012771) |
| 207QG0300X Family Medicine, Geriatric Medicine (Licence: PA OT012771) | |
| Enumeration Date | 2008-10-16 |
| Last Update Date | 2026-07-29 |