| NPI | 1407152416 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: TX Q5007) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: TX BP10040289) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: TX BP20051408) | |
| Enumeration Date | 2011-02-09 |
| Last Update Date | 2020-02-12 |