| NPI | 1780057109 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: MD A4357)  | 
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: CO 0013672)  | 
| Enumeration Date | 2015-11-06 | 
| Last Update Date | 2015-11-06 |