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 |