| NPI | 1508159930 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207QS0010X Family Medicine, Sports Medicine (Licence: CO DR.0053532) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CO DR.0053532) |
| Enumeration Date | 2011-05-18 |
| Last Update Date | 2021-08-04 |