| NPI | 1356970206 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RS0010X Internal Medicine, Sports Medicine (Licence: UT 13877164-1205) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MA 284038) |
| 2081S0010X Physical Medicine & Rehabilitation, Sports Medicine (Licence: UT 13877164-1205) | |
| Enumeration Date | 2020-04-03 |
| Last Update Date | 2024-04-26 |