| NPI | 1942720727 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207QG0300X Family Medicine, Geriatric Medicine (Licence: WI 76012) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IA R-10900) |
| 207Q00000X Family Medicine (Licence: WI 76012) | |
| 207QG0300X Family Medicine, Geriatric Medicine (Licence: GA 12183) | |
| Enumeration Date | 2017-06-22 |
| Last Update Date | 2021-11-09 |