NPI | 1912358433 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207QS0010X Family Medicine, Sports Medicine (Licence: VA 0101263087) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: VA 0101263087) |
Enumeration Date | 2016-06-27 |
Last Update Date | 2023-09-12 |