| NPI | 1649403502 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: PA OS015235) |
| Additional Taxonomies | 207QS0010X Family Medicine, Sports Medicine (Licence: OH 34.010764) |
| 207QS0010X Family Medicine, Sports Medicine (Licence: PA os015235) | |
| Enumeration Date | 2009-08-26 |
| Last Update Date | 2019-08-07 |