NPI | 1992942502 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207QS0010X Family Medicine, Sports Medicine (Licence: SC 31408) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: SC 31408) |
207P00000X Emergency Medicine (Licence: SC 31408) | |
Enumeration Date | 2009-01-20 |
Last Update Date | 2023-02-22 |