| NPI | 1023093812 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: FL ME153039) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: VA 0101236813) |
| Enumeration Date | 2005-12-14 |
| Last Update Date | 2024-02-29 |