| NPI | 1184948077 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207QS0010X Family Medicine, Sports Medicine (Licence: NY 2802661) |
| Additional Taxonomies | 207QS0010X Family Medicine, Sports Medicine (Licence: CT 54254) |
| Enumeration Date | 2010-03-21 |
| Last Update Date | 2021-04-20 |