NPI | 1003159674 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 2081S0010X Physical Medicine & Rehabilitation, Sports Medicine (Licence: NY 292907-1) |
Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: WA ML60380159) |
2081S0010X Physical Medicine & Rehabilitation, Sports Medicine (Licence: IL 125.069781) | |
Enumeration Date | 2013-04-02 |
Last Update Date | 2023-07-11 |