| NPI | 1053351007 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207QS0010X Family Medicine, Sports Medicine (Licence: MD D0071307) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MD D0071307) |
| Enumeration Date | 2006-06-07 |
| Last Update Date | 2010-09-08 |