| NPI | 1679736714 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2081S0010X Physical Medicine & Rehabilitation Sports Medicine (Licence: VA 0101269322) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: NY 265956) |
| 2081S0010X Physical Medicine & Rehabilitation Sports Medicine (Licence: NY 265956) | |
| Enumeration Date | 2008-07-09 |
| Last Update Date | 2021-06-28 |