NPI | 1972953131 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207QG0300X Family Medicine, Geriatric Medicine (Licence: NC 2020-00619) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: MA 268209) |
Enumeration Date | 2016-06-20 |
Last Update Date | 2024-09-30 |