| NPI | 1972675775 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NC 201200927) |
| Additional Taxonomies | 207QG0300X Family Medicine, Geriatric Medicine (Licence: PR 16370) |
| 207QG0300X Family Medicine, Geriatric Medicine (Licence: NC 201200927) | |
| Enumeration Date | 2006-11-15 |
| Last Update Date | 2025-10-09 |