| NPI | 1619076528 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: CA A72149) |
| Additional Taxonomies | 174400000X Specialist (Licence: CA A72149) |
| Enumeration Date | 2006-09-21 |
| Last Update Date | 2018-10-22 |