| NPI | 1730176454 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA a63827) |
| Additional Taxonomies | 207QS0010X Family Medicine, Sports Medicine (Licence: CA a63827) |
| 2083P0011X Preventive Medicine, Undersea and Hyperbaric Medicine (Licence: CA a63827) | |
| Enumeration Date | 2005-09-29 |
| Last Update Date | 2007-07-08 |