NPI | 1003435884 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: PA MD480194) |
Additional Taxonomies | 207QS0010X Family Medicine, Sports Medicine (Licence: PA MD480194) |
Enumeration Date | 2020-04-13 |
Last Update Date | 2025-01-17 |