| NPI | 1184904104 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: HI MD-19470) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CA A117971) |
| 207QS0010X Family Medicine, Sports Medicine (Licence: AZ 53027) | |
| Enumeration Date | 2011-08-22 |
| Last Update Date | 2023-10-31 |