| NPI | 1679911580 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2081S0010X Physical Medicine & Rehabilitation, Sports Medicine (Licence: MD D86141) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: PA MT205100) |
| Enumeration Date | 2013-06-13 |
| Last Update Date | 2021-08-31 |