NPI | 1295364669 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: OH 34016388) |
Additional Taxonomies | 207QS0010X Family Medicine, Sports Medicine (Licence: OH 34.016388) |
Enumeration Date | 2020-04-07 |
Last Update Date | 2024-07-08 |