NPI | 1558715896 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207QS0010X Family Medicine, Sports Medicine (Licence: SC 82428) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: SC 82428) |
207Q00000X Family Medicine (Licence: FL TRN22658) | |
207QS0010X Family Medicine, Sports Medicine (Licence: SC 20-82428) | |
Enumeration Date | 2016-04-22 |
Last Update Date | 2022-07-12 |