NPI | 1730434598 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207QG0300X Family Medicine, Geriatric Medicine (Licence: PA MD467466) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
207QG0300X Family Medicine, Geriatric Medicine (Licence: NJ 25MA09446900) | |
Enumeration Date | 2012-07-18 |
Last Update Date | 2019-09-19 |