| NPI | 1124289228 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: FL ME138973) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: PR 18037) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: VA 0116019155) | |
| Enumeration Date | 2008-06-20 |
| Last Update Date | 2021-12-17 |