| NPI | 1760416226 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207QS0010X Family Medicine, Sports Medicine (Licence: CT 034803) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CT 034803) |
| Enumeration Date | 2006-07-10 |
| Last Update Date | 2023-02-28 |