NPI | 1124378864 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: SC 36907) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: FL ME114027) |
207QG0300X Family Medicine, Geriatric Medicine (Licence: VA 0116025456) | |
Enumeration Date | 2012-09-10 |
Last Update Date | 2021-12-17 |