| 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 |