| NPI | 1780114355 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RS0010X Internal Medicine, Sports Medicine (Licence: SC 95368) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: GA 82368) |
| 207RS0010X Internal Medicine, Sports Medicine (Licence: NC 2024-01789) | |
| Enumeration Date | 2017-06-15 |
| Last Update Date | 2025-09-10 |