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 |