NPI | 1043765225 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: WA MD61686228) |
Additional Taxonomies | 2081S0010X Physical Medicine & Rehabilitation, Sports Medicine (Licence: WA MD61686228) |
Enumeration Date | 2016-08-17 |
Last Update Date | 2025-08-20 |