NPI | 1790952752 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207QS0010X Family Medicine, Sports Medicine (Licence: IL 036121994) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: IL 036121994) |
Enumeration Date | 2008-05-09 |
Last Update Date | 2020-01-16 |