| NPI | 1194772913 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: MN 48864) |
| Additional Taxonomies | 208VP0000X (Licence: PA MD068977L) |
| Enumeration Date | 2006-05-27 |
| Last Update Date | 2020-08-12 |