| NPI | 1801023254 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2081S0010X Physical Medicine & Rehabilitation, Sports Medicine (Licence: MA 267872) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 2081S0010X Physical Medicine & Rehabilitation, Sports Medicine (Licence: CA 136234) | |
| Enumeration Date | 2009-06-12 |
| Last Update Date | 2016-10-24 |