| NPI | 1154510410 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: GA 065819) |
| Additional Taxonomies | 207QS0010X Family Medicine, Sports Medicine (Licence: GA 065819) |
| Enumeration Date | 2007-10-23 |
| Last Update Date | 2023-03-10 |