| NPI | 1396972444 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: AZ 46360) |
| Additional Taxonomies | 207QS0010X Family Medicine Sports Medicine (Licence: AZ 46360) |
| Enumeration Date | 2009-06-16 |
| Last Update Date | 2014-07-01 |