| NPI | 1740714641 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207QS0010X Family Medicine, Sports Medicine (Licence: SC 41032) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: SC 41032) |
| Enumeration Date | 2017-04-18 |
| Last Update Date | 2024-08-27 |