| NPI | 1992236921 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MA T287865) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: PA OS020523) |
| 207QS0010X Family Medicine, Sports Medicine (Licence: MA T287865) | |
| Enumeration Date | 2017-03-22 |
| Last Update Date | 2023-06-09 |