| NPI | 1447791876 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207QS0010X Family Medicine, Sports Medicine (Licence: CA 20A18721) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CA 18721) |
| Enumeration Date | 2017-03-18 |
| Last Update Date | 2024-05-17 |