| NPI | 1770849366 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2081S0010X Physical Medicine & Rehabilitation Sports Medicine (Licence: CA A122300) |
| Additional Taxonomies | 2081S0010X Physical Medicine & Rehabilitation Sports Medicine (Licence: NM MD2016-0847) |
| Enumeration Date | 2012-04-08 |
| Last Update Date | 2023-10-19 |