NPI | 1952748220 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: MI 5101021428) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: PA OT015087) |
Enumeration Date | 2013-05-28 |
Last Update Date | 2023-11-27 |