| NPI | 1619330966 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2081S0010X Physical Medicine & Rehabilitation, Sports Medicine (Licence: MA 290185) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MA 267300) |
| 208100000X Physical Medicine & Rehabilitation (Licence: IL 125069738) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2016-04-04 |
| Last Update Date | 2021-10-05 |