| NPI | 1629262852 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: TX P3790) |
| Additional Taxonomies | 208D00000X General Practice (Licence: TX P3790) |
| Enumeration Date | 2007-08-30 |
| Last Update Date | 2020-06-14 |