| NPI | 1912140278 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RG0300X Internal Medicine, Geriatric Medicine (Licence: GA 79503) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: GA 79503) |
| 261QP2300X Clinic/Center, Primary Care (Licence: GA 079503) | |
| Enumeration Date | 2009-04-15 |
| Last Update Date | 2022-11-15 |