NPI | 1760636401 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207QS0010X Family Medicine, Sports Medicine (Licence: PA MD441769) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: PA MD441769) |
Enumeration Date | 2008-11-07 |
Last Update Date | 2025-02-25 |