| NPI | 1548234453 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207QS0010X Family Medicine, Sports Medicine (Licence: HI 11920) |
| Additional Taxonomies | 207QS0010X Family Medicine, Sports Medicine (Licence: CA A79631) |
| Enumeration Date | 2006-02-15 |
| Last Update Date | 2021-05-07 |