| NPI | 1689702698 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2081P0010X Physical Medicine & Rehabilitation, Pediatric Rehabilitation Medicine (Licence: SC 40616) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: NC 2007-00969) |
| 208100000X Physical Medicine & Rehabilitation (Licence: MN 46317) | |
| 2081P0010X Physical Medicine & Rehabilitation, Pediatric Rehabilitation Medicine (Licence: NC 2007-00969) | |
| 2081P0010X Physical Medicine & Rehabilitation, Pediatric Rehabilitation Medicine (Licence: VA 0101238304) | |
| Enumeration Date | 2007-03-01 |
| Last Update Date | 2020-07-06 |