| NPI | 1033137013 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207QS0010X Family Medicine, Sports Medicine (Licence: PA G72126) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CA G72126) |
| Enumeration Date | 2006-07-17 |
| Last Update Date | 2015-11-09 |