| NPI | 1346621679 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: NC 201601647) |
| Additional Taxonomies | 171000000X Military Health Care Provider |
| Enumeration Date | 2015-06-11 |
| Last Update Date | 2023-11-29 |