| NPI | 1316478217 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL os17802) |
| Additional Taxonomies | 207QS0010X Family Medicine, Sports Medicine (Licence: FL OS17802) |
| Enumeration Date | 2017-03-22 |
| Last Update Date | 2021-10-21 |