| NPI | 1063993640 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: MA PT8068) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: MA 8068) |
| Enumeration Date | 2018-08-22 |
| Last Update Date | 2018-08-22 |