| NPI | 1821294117 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207QG0300X Family Medicine, Geriatric Medicine (Licence: CA A96969) |
| Additional Taxonomies | 207QG0300X Family Medicine, Geriatric Medicine (Licence: TX N2267) |
| Enumeration Date | 2007-06-22 |
| Last Update Date | 2015-07-27 |