| NPI | 1396307476 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2083S0010X Preventive Medicine, Sports Medicine (Licence: TX AT8258) |
| Additional Taxonomies | 2083S0010X Preventive Medicine, Sports Medicine (Licence: LA 319966) |
| Enumeration Date | 2019-06-28 |
| Last Update Date | 2021-01-25 |