| NPI | 1972034890 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207QS0010X Family Medicine, Sports Medicine (Licence: CA A157793) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CA 157793) |
| 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: CA A157793) | |
| Enumeration Date | 2017-03-22 |
| Last Update Date | 2023-11-28 |