NPI | 1871086835 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207QG0300X Family Medicine, Geriatric Medicine (Licence: PA MT215214) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: PA MT215214) |
Enumeration Date | 2018-06-13 |
Last Update Date | 2022-06-21 |