NPI | 1508091034 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: TN 48036) |
Additional Taxonomies | 207QS0010X Family Medicine Sports Medicine (Licence: TN MD48036) |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2009-05-28 |
Last Update Date | 2019-01-08 |