| NPI | 1558624684 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207QS0010X Family Medicine, Sports Medicine (Licence: IN 02006800A) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NE 1145) |
| 207QS0010X Family Medicine, Sports Medicine (Licence: NE 1145) | |
| Enumeration Date | 2012-06-22 |
| Last Update Date | 2022-11-03 |