NPI | 1326429937 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207QS0010X Family Medicine, Sports Medicine (Licence: IL 036145164) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: IL 036145164) |
Enumeration Date | 2015-06-10 |
Last Update Date | 2019-10-10 |