| NPI | 1235169509 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: AK 2448) |
| Additional Taxonomies | 174400000X Specialist |
| 207QS0010X Family Medicine, Sports Medicine (Licence: AK 2448) | |
| Enumeration Date | 2006-07-03 |
| Last Update Date | 2009-12-14 |