| NPI | 1043601842 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207QS0010X Family Medicine, Sports Medicine (Licence: FL OS14412) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: FL OS14412) |
| 207QS0010X Family Medicine, Sports Medicine (Licence: GA 85870) | |
| Enumeration Date | 2015-02-15 |
| Last Update Date | 2026-08-17 |