| NPI | 1942422274 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: OH 35.088642) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: MD D71035) |
| 2081S0010X Physical Medicine & Rehabilitation, Sports Medicine (Licence: OH 35.088642) | |
| Enumeration Date | 2007-05-03 |
| Last Update Date | 2011-11-15 |