| NPI | 1205900388 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL ME96989) |
| Additional Taxonomies | 207QS0010X Family Medicine Sports Medicine (Licence: FL ME96989) |
| Enumeration Date | 2006-11-20 |
| Last Update Date | 2024-02-02 |