NPI | 1164995346 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207QA0505X Family Medicine, Adult Medicine (Licence: SC 22445) |
Additional Taxonomies | 207QG0300X Family Medicine, Geriatric Medicine (Licence: SC 22445) |
Enumeration Date | 2019-01-10 |
Last Update Date | 2023-06-13 |