NPI | 1386208866 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207QS0010X Family Medicine, Sports Medicine (Licence: CA 195848) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: IL 125.077414) |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2019-04-30 |
Last Update Date | 2024-07-22 |