| NPI | 1063405728 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: GA 80209) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: WI 24116) |
| Enumeration Date | 2005-08-29 |
| Last Update Date | 2020-07-31 |