| NPI | 1790743342 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: FL ME117366) | 
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: GA 074839) | 
| Enumeration Date | 2006-05-03 | 
| Last Update Date | 2018-07-31 |