NPI | 1073201828 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207QA0505X Family Medicine, Adult Medicine (Licence: FL 11024593) |
Additional Taxonomies | 207QG0300X Family Medicine, Geriatric Medicine (Licence: FL 11024593) |
Enumeration Date | 2023-04-28 |
Last Update Date | 2023-04-28 |