| NPI | 1386704864 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 204C00000X Neuromusculoskeletal Medicine, Sports Medicine (Licence: MA 48697) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: MA 48697) |
| 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine (Licence: MA 48697) | |
| Enumeration Date | 2006-12-12 |
| Last Update Date | 2007-07-08 |