| NPI | 1063064285 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2083S0010X Preventive Medicine, Sports Medicine (Licence: ME AC625) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: ME AC625) |
| 207QS0010X Family Medicine, Sports Medicine (Licence: ME AC625) | |
| Enumeration Date | 2019-07-09 |
| Last Update Date | 2019-07-09 |