NPI | 1154723419 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2081S0010X Physical Medicine & Rehabilitation, Sports Medicine (Licence: MD A000056) |
Additional Taxonomies | 146N00000X Emergency Medical Technician, Basic (Licence: MD 0202078) |
Enumeration Date | 2014-09-18 |
Last Update Date | 2014-09-18 |