| NPI | 1174504161 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: MO 100753) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MO 100753) |
| Enumeration Date | 2005-11-08 |
| Last Update Date | 2013-12-10 |