| NPI | 1194024695 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL ME117614) |
| Additional Taxonomies | 207QS0010X Family Medicine, Sports Medicine (Licence: FL ME117614) |
| Enumeration Date | 2011-03-23 |
| Last Update Date | 2025-07-14 |