NPI | 1245545615 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207QS0010X Family Medicine, Sports Medicine (Licence: IN 02006524A) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: MI 5101018983) |
207QS0010X Family Medicine, Sports Medicine (Licence: MI 5101018983) | |
Enumeration Date | 2010-08-10 |
Last Update Date | 2021-10-29 |