| NPI | 1609135508 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207QS0010X Family Medicine, Sports Medicine (Licence: MD H0094332) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: DE C2-0012289) |
| 207Q00000X Family Medicine (Licence: PA OS018097) | |
| 207QS0010X Family Medicine, Sports Medicine (Licence: PA OS018097) | |
| 207QS0010X Family Medicine, Sports Medicine (Licence: DE C2-0012289) | |
| Enumeration Date | 2012-05-11 |
| Last Update Date | 2024-06-25 |