| NPI | 1801897103 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CA A408630) | 
| Additional Taxonomies | 207QG0300X Family Medicine, Geriatric Medicine (Licence: CA A408630) | 
| Enumeration Date | 2005-08-09 | 
| Last Update Date | 2010-03-04 |