| NPI | 1043539257 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207QS0010X Family Medicine, Sports Medicine (Licence: NC 2017-02267) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NC 2017-02267) |
| 207Q00000X Family Medicine (Licence: MA 260631) | |
| Enumeration Date | 2010-05-27 |
| Last Update Date | 2018-05-30 |