| NPI | 1912989138 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MO R4C66) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NM 84-288) |
| 207QG0300X Family Medicine, Geriatric Medicine (Licence: NM 84-288) | |
| Enumeration Date | 2005-11-15 |
| Last Update Date | 2016-10-07 |