| NPI | 1821164849 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WA MD61273325) |
| Additional Taxonomies | 204C00000X Neuromusculoskeletal Medicine, Sports Medicine (Licence: CA A45320) |
| Enumeration Date | 2006-11-28 |
| Last Update Date | 2026-06-17 |