| NPI | 1629560636 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: OH 35.145292) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: MI 4301115567) |
| Enumeration Date | 2018-06-05 |
| Last Update Date | 2022-07-24 |