| NPI | 1073074076 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207QS0010X Family Medicine, Sports Medicine (Licence: CA 20A24507) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 207QS0010X Family Medicine, Sports Medicine (Licence: TX BP10081498) | |
| 207QS0010X Family Medicine, Sports Medicine (Licence: AZ 009249) | |
| Enumeration Date | 2019-03-31 |
| Last Update Date | 2026-03-18 |