| NPI | 1598105884 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207QS0010X Family Medicine, Sports Medicine (Licence: CT 061655) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: TN DO2966) |
| 207Q00000X Family Medicine (Licence: CT 061655) | |
| 207QS0010X Family Medicine, Sports Medicine (Licence: TN DO2966) | |
| Enumeration Date | 2013-07-01 |
| Last Update Date | 2022-09-28 |