| NPI | 1235634064 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: KY 58294) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: KY TP568) |
| 2086S0122X Surgery Plastic and Reconstructive Surgery (Licence: KY R4739) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2018-03-26 |
| Last Update Date | 2023-10-25 |