NPI | 1669649521 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207QS0010X Family Medicine, Sports Medicine (Licence: PR 016250) |
Additional Taxonomies | 207QS0010X Family Medicine, Sports Medicine (Licence: IL 036119539) |
207QS0010X Family Medicine, Sports Medicine (Licence: OH 092606) | |
207QS0010X Family Medicine, Sports Medicine (Licence: FL ME154829) | |
Enumeration Date | 2008-05-09 |
Last Update Date | 2023-12-18 |