| NPI | 1265634976 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: MO 2012023534) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: KS 04-35894) |
| 208000000X Pediatrics (Licence: MO 2012023534) | |
| 208100000X Physical Medicine & Rehabilitation (Licence: KS 04-35894) | |
| Enumeration Date | 2007-06-04 |
| Last Update Date | 2012-09-06 |