| NPI | 1518379080 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207QS0010X Family Medicine Sports Medicine (Licence: MN 71268) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CO DR0055730) |
| 207QS0010X Family Medicine Sports Medicine (Licence: OR MD182843) | |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: CO TL0005033) | |
| Enumeration Date | 2014-06-02 |
| Last Update Date | 2022-05-25 |