| NPI | 1861928061 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207QS0010X Family Medicine, Sports Medicine (Licence: MO 2022010840) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MO 2022010840) |
| 207Q00000X Family Medicine (Licence: NM MD2020-0034) | |
| 207Q00000X Family Medicine (Licence: KS 04-45474) | |
| 207Q00000X Family Medicine (Licence: TN 72087) | |
| 207QS0010X Family Medicine, Sports Medicine (Licence: MO 2020013275) | |
| Enumeration Date | 2017-05-08 |
| Last Update Date | 2025-01-06 |