| NPI | 1285122853 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 204C00000X Neuromusculoskeletal Medicine, Sports Medicine (Licence: VA 0102208155) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: VA 0102208155) |
| 207QS0010X Family Medicine, Sports Medicine (Licence: VA 0102208155) | |
| Enumeration Date | 2018-04-28 |
| Last Update Date | 2024-03-04 |