| NPI | 1750731725 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WI 72810) |
| Additional Taxonomies | 207QS0010X Family Medicine, Sports Medicine (Licence: WI 72810) |
| Enumeration Date | 2016-06-20 |
| Last Update Date | 2023-09-20 |