| NPI | 1528560828 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101Y00000X Counselor |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 2081S0010X Physical Medicine & Rehabilitation, Sports Medicine (Licence: MA 3307) | |
| Enumeration Date | 2018-03-02 |
| Last Update Date | 2023-08-31 |