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 |