| NPI | 1780616011 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: MI JL4301055419) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: OH 35054104) |
| Enumeration Date | 2006-07-07 |
| Last Update Date | 2007-07-08 |