| NPI | 1518372846 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: ID M-13130) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: ID MRM-1390) |
| 207QS0010X Family Medicine Sports Medicine (Licence: ID M-13130) | |
| Enumeration Date | 2014-06-25 |
| Last Update Date | 2023-12-15 |