| NPI | 1164942868 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: WA MD60965451) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: MI 4301112655) |
| Enumeration Date | 2017-06-23 |
| Last Update Date | 2022-10-18 |