| NPI | 1952864381 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2083S0010X Preventive Medicine Sports Medicine (Licence: CO 70248) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: WV 70248) |
| Enumeration Date | 2019-04-11 |
| Last Update Date | 2024-08-01 |