| NPI | 1174553184 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WA MD60361317) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CA A80130) |
| 207QS0010X Family Medicine, Sports Medicine (Licence: WA MD60361317w) | |
| Enumeration Date | 2006-07-04 |
| Last Update Date | 2021-01-27 |