| NPI | 1902808835 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207QG0300X Family Medicine, Geriatric Medicine (Licence: MD D0070877) |
| Additional Taxonomies | 207QG0300X Family Medicine, Geriatric Medicine (Licence: CT 043218) |
| Enumeration Date | 2005-08-11 |
| Last Update Date | 2011-10-18 |