| NPI | 1255572103 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: WA MD60682180) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: AL 30298) |
| 208100000X Physical Medicine & Rehabilitation (Licence: VA 0101250072) | |
| Enumeration Date | 2009-03-23 |
| Last Update Date | 2016-10-19 |