NPI | 1073515078 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207QS0010X Family Medicine, Sports Medicine (Licence: AZ 004187) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: AZ 004187) |
Enumeration Date | 2005-08-10 |
Last Update Date | 2024-04-23 |