| NPI | 1952745655 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207QS0010X Family Medicine, Sports Medicine (Licence: AR E10934) |
| Additional Taxonomies | 207QS0010X Family Medicine, Sports Medicine (Licence: TX Q8312) |
| Enumeration Date | 2013-04-24 |
| Last Update Date | 2020-12-14 |