| NPI | 1497789499 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA A69200) |
| Additional Taxonomies | 207QS0010X Family Medicine, Sports Medicine (Licence: CA A69200) |
| 207Q00000X Family Medicine (Licence: PA MD071455L) | |
| 207QS0010X Family Medicine, Sports Medicine (Licence: PA MD071455L) | |
| Enumeration Date | 2006-07-10 |
| Last Update Date | 2013-04-04 |