| NPI | 1710111976 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207RS0010X Internal Medicine, Sports Medicine (Licence: CA C157971) | 
| Additional Taxonomies | 207RS0010X Internal Medicine, Sports Medicine (Licence: OH 35.098194) | 
| Enumeration Date | 2009-05-04 | 
| Last Update Date | 2024-04-22 |