| NPI | 1154583862 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207QS0010X Family Medicine, Sports Medicine (Licence: KS 05-37550) |
| Additional Taxonomies | 207QS0010X Family Medicine, Sports Medicine (Licence: IN 02003812A) |
| Enumeration Date | 2008-06-25 |
| Last Update Date | 2014-09-05 |