| NPI | 1235404328 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225400000X Rehabilitation Practitioner |
| Additional Taxonomies | 305R00000X Preferred Provider Organization |
| Enumeration Date | 2012-03-21 |
| Last Update Date | 2014-10-30 |