| NPI | 1447678628 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 208VP0000X (Licence: FL OS17483) | 
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: MN 59716) | 
| 208VP0000X (Licence: MN 59716) | |
| Enumeration Date | 2014-04-03 | 
| Last Update Date | 2021-06-29 |