| NPI | 1598970840 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207QS0010X Family Medicine, Sports Medicine (Licence: NC 2010-00461)  | 
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NC 2010-00461)  | 
| 207RS0010X Internal Medicine, Sports Medicine (Licence: NC 2010-00461)  | |
| 208D00000X General Practice (Licence: NC 2010-00461)  | |
| Enumeration Date | 2007-05-11 | 
| Last Update Date | 2024-07-15 |