| NPI | 1629324736 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: WI 65481) |
| Additional Taxonomies | 208600000X Surgery (Licence: MI 4301100666) |
| Enumeration Date | 2012-07-25 |
| Last Update Date | 2019-01-10 |