| NPI | 1902242902 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NC 2016-00579) |
| Additional Taxonomies | 207QS0010X Family Medicine, Sports Medicine (Licence: NC 2016-00579) |
| 207RS0010X Internal Medicine, Sports Medicine (Licence: NC 2016-00579) | |
| Enumeration Date | 2013-05-16 |
| Last Update Date | 2023-12-18 |