| NPI | 1821483942 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207QS0010X Family Medicine, Sports Medicine (Licence: FL ME146004) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: FL ME146004) |
| 207Q00000X Family Medicine (Licence: HI MD-19703) | |
| Enumeration Date | 2015-04-06 |
| Last Update Date | 2025-10-31 |