NPI | 1134373400 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 2081S0010X Physical Medicine & Rehabilitation, Sports Medicine (Licence: MN 52253) |
Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: MN 52253) |
208100000X Physical Medicine & Rehabilitation (Licence: WA MD60346762) | |
Enumeration Date | 2008-11-12 |
Last Update Date | 2021-02-16 |