NPI | 1013398486 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207QG0300X Family Medicine, Geriatric Medicine (Licence: PA MD471595) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: PA MT209468) |
207QG0300X Family Medicine, Geriatric Medicine (Licence: FL ME167217) | |
207QG0300X Family Medicine, Geriatric Medicine (Licence: GA 100529) | |
Enumeration Date | 2015-06-11 |
Last Update Date | 2025-09-09 |