NPI | 1235260480 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 204C00000X Neuromusculoskeletal Medicine, Sports Medicine (Licence: MO 2000163872) |
Additional Taxonomies | 204D00000X Neuromusculoskeletal Medicine & OMM (Licence: KS 31371) |
207Q00000X Family Medicine (Licence: KS 31371) | |
207Q00000X Family Medicine (Licence: MO 2000163872) | |
Enumeration Date | 2007-03-08 |
Last Update Date | 2007-07-08 |