| NPI | 1316343221 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207QS0010X Family Medicine, Sports Medicine (Licence: PR 018937) |
| Additional Taxonomies | 208D00000X General Practice (Licence: PR 018937) |
| Enumeration Date | 2014-11-05 |
| Last Update Date | 2024-09-19 |