| NPI | 1023087467 |
|---|---|
| Other Name | SANDRA LANE JOSEPH |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207QS0010X Family Medicine, Sports Medicine (Licence: FL ME136355) |
| Additional Taxonomies | 207QS0010X Family Medicine, Sports Medicine (Licence: OH 35052191) |
| Enumeration Date | 2006-03-17 |
| Last Update Date | 2020-01-14 |