| NPI | 1972581635 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NH 13329) |
| Additional Taxonomies | 207QS0010X Family Medicine, Sports Medicine (Licence: NH 13329) |
| Enumeration Date | 2006-01-04 |
| Last Update Date | 2019-01-17 |