| NPI | 1043270903 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CO 41783) |
| Additional Taxonomies | 207QS0010X Family Medicine, Sports Medicine (Licence: MO 2026035426) |
| 207QS0010X Family Medicine, Sports Medicine (Licence: CO 41783) | |
| Enumeration Date | 2006-03-24 |
| Last Update Date | 2026-08-23 |