| NPI | 1477836831 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2081P0010X Physical Medicine & Rehabilitation, Pediatric Rehabilitation Medicine (Licence: MN 59101) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: PA MT197048) |
| Enumeration Date | 2011-09-22 |
| Last Update Date | 2016-03-01 |