| NPI | 1629275268 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: FL ME137017) | 
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: MI 4301090595) | 
| 2081H0002X Physical Medicine & Rehabilitation, Hospice and Palliative Medicine (Licence: OH 35.120057) | |
| Enumeration Date | 2007-06-28 | 
| Last Update Date | 2019-08-05 |