NPI | 1003169814 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207QG0300X Family Medicine, Geriatric Medicine (Licence: NH 21643) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: PA MT202492) |
207Q00000X Family Medicine (Licence: NH 21643) | |
207QG0300X Family Medicine, Geriatric Medicine (Licence: PA MD456243) | |
Enumeration Date | 2012-10-17 |
Last Update Date | 2021-10-12 |