| NPI | 1477916245 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2081S0010X Physical Medicine & Rehabilitation, Sports Medicine (Licence: OH 34015536) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: MO 2021015390) |
| 208100000X Physical Medicine & Rehabilitation (Licence: PA OS020601) | |
| 2081S0010X Physical Medicine & Rehabilitation, Sports Medicine (Licence: MO 2021015390) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2016-03-30 |
| Last Update Date | 2022-12-21 |