| NPI | 1417411471 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171W00000X Contractor |
| Additional Taxonomies | 174400000X Specialist |
| 225400000X Rehabilitation Practitioner | |
| Enumeration Date | 2019-01-24 |
| Last Update Date | 2019-01-24 |