| NPI | 1497317861 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207QS0010X Family Medicine, Sports Medicine (Licence: NE 33270) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NE 33270) |
| Enumeration Date | 2019-07-05 |
| Last Update Date | 2024-05-23 |