| NPI | 1255747861 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207QS0010X Family Medicine, Sports Medicine (Licence: CO DR.0060410) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: AL MD.35945) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2014-07-02 |
| Last Update Date | 2023-05-04 |