| NPI | 1902919806 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 204C00000X Neuromusculoskeletal Medicine, Sports Medicine (Licence: TX H3194) |
| Additional Taxonomies | 208D00000X General Practice (Licence: WI 27342-20) |
| Enumeration Date | 2006-08-16 |
| Last Update Date | 2021-08-17 |