| NPI | 1700858156 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207QS0010X Family Medicine, Sports Medicine (Licence: AZ 32288) |
| Additional Taxonomies | 174400000X Specialist (Licence: AZ 32288) |
| Enumeration Date | 2006-02-01 |
| Last Update Date | 2016-09-02 |