NPI | 1518496611 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207QS0010X Family Medicine, Sports Medicine (Licence: PA MD474020) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: PA MD474020) |
Enumeration Date | 2017-06-12 |
Last Update Date | 2023-06-15 |