| NPI | 1811499825 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2081S0010X Physical Medicine & Rehabilitation, Sports Medicine (Licence: AL 2000019735) |
| Additional Taxonomies | 207PS0010X Emergency Medicine, Sports Medicine (Licence: AL 1745) |
| Enumeration Date | 2018-03-06 |
| Last Update Date | 2018-03-06 |