NPI | 1396056941 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207RS0010X Internal Medicine, Sports Medicine (Licence: PA OS018555) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA OS018555) |
261QP2300X Clinic/Center, Primary Care | |
Enumeration Date | 2010-06-29 |
Last Update Date | 2024-02-29 |