| NPI | 1952982779 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207QS0010X Family Medicine, Sports Medicine (Licence: UT 13877177-1205) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CO TL.0008551) |
| Enumeration Date | 2021-04-15 |
| Last Update Date | 2024-04-09 |