| NPI | 1902822687 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: PA MD456608) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: WI 34432-020) |
| 208100000X Physical Medicine & Rehabilitation (Licence: TX N5303) | |
| 208100000X Physical Medicine & Rehabilitation (Licence: OH 35.129337) | |
| Enumeration Date | 2006-07-14 |
| Last Update Date | 2019-01-02 |