| NPI | 1427588599 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207QS0010X Family Medicine, Sports Medicine (Licence: MI 5101026490) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NV DO2768) |
| 207Q00000X Family Medicine (Licence: PA OT017953) | |
| Enumeration Date | 2017-06-12 |
| Last Update Date | 2022-07-21 |