| NPI | 1245213396 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: WA MD60405789) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: WY 10678A) |
| Enumeration Date | 2005-11-22 |
| Last Update Date | 2019-08-29 |