| NPI | 1093135410 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2081S0010X Physical Medicine & Rehabilitation Sports Medicine (Licence: MI 5101024389) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: MI 5101024389) |
| Enumeration Date | 2014-04-24 |
| Last Update Date | 2020-11-11 |