NPI | 1922065028 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207QS0010X Family Medicine, Sports Medicine (Licence: OH 35081611) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: OH 35081611) |
Enumeration Date | 2006-05-01 |
Last Update Date | 2021-03-25 |