| NPI | 1003476250 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207QG0300X Family Medicine, Geriatric Medicine (Licence: PA MT219074) |
| Additional Taxonomies | 208D00000X General Practice (Licence: GA 87682) |
| Enumeration Date | 2019-06-19 |
| Last Update Date | 2021-05-05 |