| NPI | 1255750345 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207QG0300X Family Medicine, Geriatric Medicine (Licence: NH EL31532) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: AZ 57805) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2014-04-16 |
| Last Update Date | 2024-08-23 |