| NPI | 1457379802 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: TX L6029) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: NC 200301355) |
| Enumeration Date | 2006-07-17 |
| Last Update Date | 2021-12-07 |