| NPI | 1750623997 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: FL ME136400) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: NC 2017-01351) |
| Enumeration Date | 2013-03-26 |
| Last Update Date | 2018-09-20 |