NPI | 1679796775 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207QS0010X Family Medicine Sports Medicine (Licence: IN 02003257A) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: IN 02003257A) |
Enumeration Date | 2007-04-10 |
Last Update Date | 2023-11-27 |