| NPI | 1053039404 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: FL 41743) | 
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: WA 61343198) | 
| Enumeration Date | 2022-08-19 | 
| Last Update Date | 2024-06-14 |