NPI | 1003806977 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207QG0300X Family Medicine, Geriatric Medicine (Licence: PA MD039267L) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: FL ME158311) |
207Q00000X Family Medicine (Licence: PA MD039267L) | |
Enumeration Date | 2005-10-24 |
Last Update Date | 2023-11-08 |