| NPI | 1295773901 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: OR MD20521) |
| Additional Taxonomies | 207QS0010X Family Medicine, Sports Medicine (Licence: OR MD20521) |
| Enumeration Date | 2006-06-03 |
| Last Update Date | 2020-04-23 |