| NPI | 1932223047 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207QS0010X Family Medicine, Sports Medicine (Licence: AK 7334) |
| Additional Taxonomies | 207QS0010X Family Medicine, Sports Medicine (Licence: HI MD9413) |
| Enumeration Date | 2007-03-16 |
| Last Update Date | 2015-10-28 |