| NPI | 1508817107 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: MA 60569) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CT 29145) |
| Enumeration Date | 2006-05-16 |
| Last Update Date | 2021-11-11 |