| NPI | 1962628107 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: WA MD00041527) |
| Additional Taxonomies | 2081H0002X (Licence: WA MD00041527) |
| Enumeration Date | 2007-04-17 |
| Last Update Date | 2017-07-24 |