| NPI | 1982970232 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: AL DO.1599) |
| Additional Taxonomies | 207QS0010X Family Medicine, Sports Medicine (Licence: AL DO.1599) |
| Enumeration Date | 2012-03-30 |
| Last Update Date | 2017-03-20 |