| NPI | 1831301126 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: KS 04-32541) |
| Additional Taxonomies | 207QS0010X Family Medicine, Sports Medicine (Licence: MO 2010014070) |
| Enumeration Date | 2007-05-07 |
| Last Update Date | 2013-08-14 |