NPI | 1396308557 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: PA OT019378) |
Additional Taxonomies | 207QS0010X Family Medicine, Sports Medicine (Licence: PA OT019378) |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2019-04-15 |
Last Update Date | 2022-07-06 |