| NPI | 1093943771 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MI 4301100233) |
| Additional Taxonomies | 207QS0010X Family Medicine, Sports Medicine (Licence: MI 4301100233) |
| Enumeration Date | 2009-07-01 |
| Last Update Date | 2021-07-19 |