| NPI | 1073928834 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: NY 294681) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: OH 35.133236) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2014-06-30 |
| Last Update Date | 2020-06-04 |