| NPI | 1093071094 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207QS0010X Family Medicine, Sports Medicine (Licence: MI 4301107540) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MI 4301107540) |
| Enumeration Date | 2012-04-04 |
| Last Update Date | 2024-02-29 |