NPI | 1073048773 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: MN 73438) |
Additional Taxonomies | 208D00000X General Practice (Licence: IA MD-45465) |
171000000X Military Health Care Provider | |
Enumeration Date | 2017-05-01 |
Last Update Date | 2024-02-13 |