| NPI | 1669680823 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: TX H3214) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: AZ 19247) |
| 208100000X Physical Medicine & Rehabilitation (Licence: CA A47720) | |
| Enumeration Date | 2007-05-20 |
| Last Update Date | 2007-07-08 |