| NPI | 1568454890 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207QS0010X Family Medicine, Sports Medicine (Licence: PA MD422473) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: PA MD422473) |
| 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: PA MD422473) | |
| Enumeration Date | 2005-08-23 |
| Last Update Date | 2014-01-16 |