| NPI | 1538496419 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA A109662) |
| Additional Taxonomies | 207PS0010X Emergency Medicine, Sports Medicine (Licence: CA A109662) |
| 282N00000X General Acute Care Hospital (Licence: CA A109662) | |
| Enumeration Date | 2009-11-12 |
| Last Update Date | 2024-09-17 |