| NPI | 1316143886 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207QS0010X Family Medicine, Sports Medicine (Licence: WA MD00046953) |
| Additional Taxonomies | 207QS0010X Family Medicine, Sports Medicine (Licence: ID M-10668) |
| 207Q00000X Family Medicine (Licence: ID M-10668) | |
| 207Q00000X Family Medicine (Licence: WA MD00046953) | |
| Enumeration Date | 2007-06-22 |
| Last Update Date | 2025-07-18 |