| NPI | 1063156487 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207PS0010X Emergency Medicine, Sports Medicine (Licence: NY 336443) |
| Additional Taxonomies | 207PS0010X Emergency Medicine, Sports Medicine (Licence: CA 20A25381) |
| Enumeration Date | 2022-04-21 |
| Last Update Date | 2026-06-09 |