| NPI | 1629336409 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: MA 256289) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: MD 0000000) |
| Enumeration Date | 2012-04-30 |
| Last Update Date | 2016-08-04 |