| NPI | 1649346172 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207QS0010X Family Medicine, Sports Medicine (Licence: MO 111299) |
| Additional Taxonomies | 207QS0010X Family Medicine, Sports Medicine (Licence: OK 3064) |
| 207QS0010X Family Medicine, Sports Medicine (Licence: KS 05-27522) | |
| Enumeration Date | 2006-11-27 |
| Last Update Date | 2024-11-01 |