| NPI | 1447888482 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208VP0000X (Licence: FL ME167583) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: MN 69520) |
| Enumeration Date | 2020-03-27 |
| Last Update Date | 2025-02-20 |