| NPI | 1063987279 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207QG0300X Family Medicine, Geriatric Medicine (Licence: PR 22356) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: PR 34968) |
| 207Q00000X Family Medicine (Licence: PR 15245-I) | |
| 207Q00000X Family Medicine (Licence: PR 22356) | |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: PR 22356) | |
| Enumeration Date | 2018-10-04 |
| Last Update Date | 2023-08-03 |