NPI | 1770746554 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207QG0300X Family Medicine, Geriatric Medicine (Licence: AZ 55748) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: TX P3193) |
Enumeration Date | 2008-07-02 |
Last Update Date | 2018-06-13 |