| NPI | 1841408747 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207QS0010X Family Medicine, Sports Medicine (Licence: TX N5467) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: AZ 64511) |
| 207Q00000X Family Medicine (Licence: TX N5467) | |
| 207QS0010X Family Medicine, Sports Medicine (Licence: AZ 64511) | |
| 207QS0010X Family Medicine, Sports Medicine (Licence: SC 93411) | |
| Enumeration Date | 2007-05-21 |
| Last Update Date | 2024-10-11 |