| NPI | 1669646311 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207QS0010X Family Medicine, Sports Medicine (Licence: MN 51006) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CA A112874) |
| 207Q00000X Family Medicine (Licence: MN 51006) | |
| 207QS0010X Family Medicine, Sports Medicine (Licence: CA A112874) | |
| Enumeration Date | 2008-04-14 |
| Last Update Date | 2015-07-02 |