| NPI | 1972982494 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: PA OS020066) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: VA 0116028892) |
| Enumeration Date | 2015-05-29 |
| Last Update Date | 2021-02-08 |