| NPI | 1487629739 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: NC 2011-01899) |
| Additional Taxonomies | 174400000X Specialist (Licence: PA OS012220) |
| 208100000X Physical Medicine & Rehabilitation (Licence: TX N2226) | |
| Enumeration Date | 2006-02-21 |
| Last Update Date | 2012-03-05 |