| NPI | 1720625544 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2081S0010X Physical Medicine & Rehabilitation, Sports Medicine (Licence: TX AT7689) |
| Additional Taxonomies | 2083S0010X Preventive Medicine, Sports Medicine (Licence: TX AT7689) |
| Enumeration Date | 2019-12-01 |
| Last Update Date | 2019-12-01 |