| NPI | 1568816478 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207QS0010X Family Medicine, Sports Medicine (Licence: VA 0101271171) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: VA 0101271171) |
| Enumeration Date | 2016-04-17 |
| Last Update Date | 2022-10-30 |