| NPI | 1053489815 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: WI 51962) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: WI 51962) |
| Enumeration Date | 2006-12-01 |
| Last Update Date | 2015-08-21 |