| NPI | 1104267012 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: MA 278662) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: MI 4301103216) |
| Enumeration Date | 2013-07-09 |
| Last Update Date | 2019-08-15 |