NPI | 1003113762 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207RG0300X Internal Medicine, Geriatric Medicine (Licence: CT 63896) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: CA PA21430) |
Enumeration Date | 2011-02-16 |
Last Update Date | 2020-06-30 |