| NPI | 1063894574 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207QS0010X Family Medicine Sports Medicine (Licence: CO DR.0070802) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NE 29700) |
| 207Q00000X Family Medicine (Licence: CO DR.0070802) | |
| 207QS0010X Family Medicine Sports Medicine (Licence: NE 29700) | |
| Enumeration Date | 2015-06-19 |
| Last Update Date | 2024-03-04 |