NPI | 1871122630 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA 20A19387) |
Additional Taxonomies | 207QS0010X Family Medicine, Sports Medicine (Licence: CA 20A19387) |
Enumeration Date | 2020-04-03 |
Last Update Date | 2025-06-26 |