NPI | 1215128202 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207QG0300X Family Medicine, Geriatric Medicine (Licence: CT 056905) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: NC 2009-01180) |
208D00000X General Practice (Licence: NC 2009-01180) | |
Enumeration Date | 2007-08-06 |
Last Update Date | 2022-07-11 |