| NPI | 1669572046 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MO 2009009791) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: PR 13125) |
| Enumeration Date | 2006-09-25 |
| Last Update Date | 2019-10-14 |