| NPI | 1770142234 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207QS0010X Family Medicine, Sports Medicine (Licence: PA OS022767) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: PA OT018998) |
| Enumeration Date | 2019-06-10 |
| Last Update Date | 2024-08-08 |