NPI | 1114192218 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207QS0010X Family Medicine, Sports Medicine (Licence: WA OP60017447) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: WA OP60017447) |
Enumeration Date | 2008-04-29 |
Last Update Date | 2022-12-20 |