| NPI | 1336709013 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207QS0010X Family Medicine, Sports Medicine (Licence: PA MD483332) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: PA MD483332) |
| 207QS0010X Family Medicine, Sports Medicine (Licence: UT 12730930-1205) | |
| Enumeration Date | 2019-06-16 |
| Last Update Date | 2024-10-17 |