| NPI | 1710999867 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207QS0010X Family Medicine Sports Medicine (Licence: CA A82795) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CA A82795) |
| Enumeration Date | 2006-08-13 |
| Last Update Date | 2024-01-22 |