| NPI | 1528283199 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MI 5101016018) |
| Additional Taxonomies | 207QS0010X Family Medicine Sports Medicine (Licence: MI 5101016018) |
| Enumeration Date | 2007-04-17 |
| Last Update Date | 2024-02-15 |