| NPI | 1205286465 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207QG0300X Family Medicine, Geriatric Medicine (Licence: NY 305746) |
| Additional Taxonomies | 207QG0300X Family Medicine, Geriatric Medicine (Licence: MI 4351027879) |
| 207QH0002X Family Medicine, Hospice and Palliative Medicine (Licence: NY 305746) | |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: MI 4301110541) | |
| Enumeration Date | 2016-06-20 |
| Last Update Date | 2021-06-16 |