| NPI | 1871503938 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 2081S0010X Physical Medicine & Rehabilitation, Sports Medicine (Licence: MN 27105)  | 
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MN 27150)  | 
| 2083X0100X Preventive Medicine, Occupational Medicine (Licence: MN 27150)  | |
| Enumeration Date | 2006-08-09 | 
| Last Update Date | 2016-04-07 |