| NPI | 1710005228 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: OR ORMD15820) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: WA 02529MD00019998) |
| Enumeration Date | 2007-03-26 |
| Last Update Date | 2007-07-08 |