| NPI | 1033166012 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: AZ 31231) |
| Additional Taxonomies | 207QS0010X Family Medicine Sports Medicine (Licence: AZ 31231) |
| 208100000X Physical Medicine & Rehabilitation (Licence: AZ 31231) | |
| Enumeration Date | 2006-05-27 |
| Last Update Date | 2019-05-23 |