| NPI | 1396126249 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2081S0010X Physical Medicine & Rehabilitation Sports Medicine (Licence: CA A161294) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: PA MT211203) |
| Enumeration Date | 2015-06-17 |
| Last Update Date | 2020-07-20 |