| NPI | 1992756472 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207QS0010X Family Medicine, Sports Medicine (Licence: CA G71759) |
| Additional Taxonomies | 207QS0010X Family Medicine, Sports Medicine (Licence: PA G71759) |
| Enumeration Date | 2006-05-12 |
| Last Update Date | 2013-01-02 |