NPI | 1023514056 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207QS0010X Family Medicine, Sports Medicine (Licence: MA 287799) |
Additional Taxonomies | 208000000X Pediatrics (Licence: MA 287799) |
Enumeration Date | 2018-03-30 |
Last Update Date | 2022-06-14 |