| NPI | 1588028344 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: GA 91972) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: FL OS18473) |
| 207Q00000X Family Medicine (Licence: OH 34.013856) | |
| 207QS0010X Family Medicine Sports Medicine (Licence: FL OS18473) | |
| 207QS0010X Family Medicine Sports Medicine (Licence: VT 0320133913) | |
| Enumeration Date | 2016-04-07 |
| Last Update Date | 2024-02-12 |