| NPI | 1962468959 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: ME md24876) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MA 214075) |
| 207QG0300X Family Medicine, Geriatric Medicine (Licence: MA 214075) | |
| Enumeration Date | 2006-04-26 |
| Last Update Date | 2021-09-03 |