| NPI | 1710336029 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207QS0010X Family Medicine, Sports Medicine (Licence: VA 0101270214) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: SC LL39425) |
| 207Q00000X Family Medicine (Licence: VA 0101270214) | |
| Enumeration Date | 2016-06-07 |
| Last Update Date | 2021-10-31 |