| NPI | 1104403963 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207QS0010X Family Medicine, Sports Medicine (Licence: CA A196389) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: CA A196389) |
| Enumeration Date | 2021-03-26 |
| Last Update Date | 2025-08-07 |