NPI | 1093071094 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207QS0010X Family Medicine, Sports Medicine (Licence: MI 4301107540) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: MI 4301107540) |
Enumeration Date | 2012-04-04 |
Last Update Date | 2024-02-29 |