| NPI | 1760773469 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: WA MD60910228) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: PA MT208696) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2011-04-28 |
| Last Update Date | 2020-10-02 |