| NPI | 1356424691 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207QS0010X Family Medicine, Sports Medicine (Licence: WI 47287) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: WI 47287) |
| Enumeration Date | 2006-10-23 |
| Last Update Date | 2020-12-09 |