| NPI | 1205843406 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: OR PT1520) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: WA PT60157690) |
| Enumeration Date | 2006-08-01 |
| Last Update Date | 2013-02-05 |