NPI | 1801048202 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207QG0300X Family Medicine, Geriatric Medicine (Licence: SC 36736) |
Additional Taxonomies | 207QG0300X Family Medicine, Geriatric Medicine (Licence: PA OT012771) |
207Q00000X Family Medicine (Licence: PA OT012771) | |
Enumeration Date | 2008-10-16 |
Last Update Date | 2021-06-07 |