| NPI | 1104905231 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: VA 0101256434) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: CA A95733) |
| 2081P0301X Physical Medicine & Rehabilitation, Brain Injury Medicine (Licence: VA 0101256434) | |
| 208100000X Physical Medicine & Rehabilitation (Licence: MI 4301099875) | |
| Enumeration Date | 2006-11-02 |
| Last Update Date | 2020-06-03 |