| NPI | 1659803070 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2081P0010X Physical Medicine & Rehabilitation Pediatric Rehabilitation Medicine (Licence: KY 58181) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: KY TP456) |
| 208100000X Physical Medicine & Rehabilitation (Licence: KY 58181) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2017-04-03 |
| Last Update Date | 2023-10-25 |