| NPI | 1790123370 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2081S0010X Physical Medicine & Rehabilitation, Sports Medicine (Licence: TX S5871) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: AZ R74029) |
| 208100000X Physical Medicine & Rehabilitation (Licence: TX BP10050010) | |
| 208100000X Physical Medicine & Rehabilitation (Licence: TX S5871) | |
| 2081S0010X Physical Medicine & Rehabilitation, Sports Medicine (Licence: CA 150270) | |
| Enumeration Date | 2013-06-05 |
| Last Update Date | 2022-07-21 |