NPI | 1598031668 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 2081S0010X Physical Medicine & Rehabilitation, Sports Medicine (Licence: NY 288435) |
Additional Taxonomies | 2080S0010X Pediatrics, Sports Medicine (Licence: NY 288435) |
208100000X Physical Medicine & Rehabilitation (Licence: NY 288435) | |
Enumeration Date | 2012-03-22 |
Last Update Date | 2023-07-26 |