| NPI | 1669790598 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: OK 5720) |
| Additional Taxonomies | 207QS0010X Family Medicine, Sports Medicine (Licence: OK 5720) |
| Enumeration Date | 2010-05-17 |
| Last Update Date | 2022-03-09 |