| NPI | 1003070640 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NV 13322) |
| Additional Taxonomies | 207QS0010X Family Medicine, Sports Medicine (Licence: NV 13322) |
| 207QS0010X Family Medicine, Sports Medicine (Licence: CA A98140) | |
| Enumeration Date | 2008-07-14 |
| Last Update Date | 2021-06-21 |