| NPI | 1801015029 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: WA MD32124) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: WA MD00032124) |
| Enumeration Date | 2007-04-25 |
| Last Update Date | 2019-06-24 |