| NPI | 1700266608 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: FL OS16125) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: MI 5101021920) |
| 208D00000X General Practice (Licence: MI 5101021920) | |
| Enumeration Date | 2015-06-05 |
| Last Update Date | 2021-04-22 |