| NPI | 1255836128 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207QS0010X Family Medicine, Sports Medicine (Licence: OR DO211472) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: OR DO211472) |
| Enumeration Date | 2018-03-24 |
| Last Update Date | 2023-11-29 |