| NPI | 1477180842 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 2081S0010X Physical Medicine & Rehabilitation, Sports Medicine (Licence: IA MD-52768)  | 
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program | 
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: CO TL.0008524)  | |
| Enumeration Date | 2020-03-25 | 
| Last Update Date | 2024-03-13 |