| NPI | 1376518662 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA C50851) |
| Additional Taxonomies | 207QS0010X Family Medicine, Sports Medicine (Licence: CA C50851) |
| 207Q00000X Family Medicine (Licence: PA MD423177) | |
| 207QS0010X Family Medicine, Sports Medicine (Licence: PA MD423177) | |
| Enumeration Date | 2006-02-21 |
| Last Update Date | 2018-10-17 |