| NPI | 1316983265 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207QS0010X Family Medicine, Sports Medicine (Licence: CO 035644) |
| Additional Taxonomies | 207QS0010X Family Medicine, Sports Medicine (Licence: CO 0035644) |
| Enumeration Date | 2006-06-21 |
| Last Update Date | 2020-03-24 |