| NPI | 1053668103 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: FL 32719) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: CT 9515) |
| Enumeration Date | 2012-08-08 |
| Last Update Date | 2018-03-17 |