| NPI | 1790976710 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2081S0010X Physical Medicine & Rehabilitation Sports Medicine (Licence: PA OS018936) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA OTO12195) |
| 208100000X Physical Medicine & Rehabilitation (Licence: GA 067900) | |
| Enumeration Date | 2007-08-06 |
| Last Update Date | 2018-04-23 |