NPI | 1285122853 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 204C00000X Neuromusculoskeletal Medicine, Sports Medicine (Licence: VA 0102208155) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: VA 0102208155) |
207QS0010X Family Medicine, Sports Medicine (Licence: VA 0102208155) | |
Enumeration Date | 2018-04-28 |
Last Update Date | 2024-03-04 |