| 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 |