| NPI | 1962559302 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207QA0000X Family Medicine Adolescent Medicine (Licence: WI 41182) |
| Additional Taxonomies | 207QG0300X Family Medicine Geriatric Medicine (Licence: WI 41182) |
| Enumeration Date | 2007-01-05 |
| Last Update Date | 2023-06-28 |