NPI | 1508398520 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: CA 173247) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: 63832) |
Enumeration Date | 2017-03-29 |
Last Update Date | 2021-09-16 |