| NPI | 1164670550 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207QS0010X Family Medicine, Sports Medicine (Licence: NV DO1606) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CA 20A16827) |
| 207QS0010X Family Medicine, Sports Medicine (Licence: CA 20A16827) | |
| Enumeration Date | 2008-08-28 |
| Last Update Date | 2022-05-06 |