| NPI | 1760636401 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207QS0010X Family Medicine, Sports Medicine (Licence: PA MD441769) |
| Additional Taxonomies | 207QS0010X Family Medicine, Sports Medicine (Licence: CT 51100) |
| Enumeration Date | 2008-11-07 |
| Last Update Date | 2024-01-15 |