| 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 (Licence: OH 35.120057) | |
| Enumeration Date | 2007-06-28 |
| Last Update Date | 2019-08-05 |