| NPI | 1447466594 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2081S0010X Physical Medicine & Rehabilitation, Sports Medicine (Licence: TX M4594) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: TX M4594) |
| Enumeration Date | 2007-05-15 |
| Last Update Date | 2014-10-14 |