| NPI | 1255891891 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207QS0010X Family Medicine, Sports Medicine (Licence: KS 05-47756) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: OH 34.015287) |
| Enumeration Date | 2019-03-20 |
| Last Update Date | 2024-08-21 |