| NPI | 1932205259 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207QS0010X Family Medicine, Sports Medicine (Licence: CO DR.0039161) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CO 39161) |
| Enumeration Date | 2006-09-15 |
| Last Update Date | 2014-08-18 |