| NPI | 1912343823 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2081S0010X Physical Medicine & Rehabilitation Sports Medicine (Licence: ME MD22373) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: PA DONT-HAVE-ONE-YET) |
| Enumeration Date | 2013-05-18 |
| Last Update Date | 2018-11-19 |