| NPI | 1023058278 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA G156448) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: UT 173729-1205) |
| 207QS0010X Family Medicine, Sports Medicine (Licence: CA G156448) | |
| 207QS0010X Family Medicine, Sports Medicine (Licence: UT 173729-1205) | |
| Enumeration Date | 2006-06-07 |
| Last Update Date | 2018-08-13 |