| NPI | 1053737403 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: TX J4075)  | 
| Additional Taxonomies | 174400000X Specialist (Licence: TX J4075)  | 
| 2081P0004X Physical Medicine & Rehabilitation, Spinal Cord Injury Medicine (Licence: TX J4075)  | |
| 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine (Licence: TX J4075)  | |
| 2081S0010X Physical Medicine & Rehabilitation, Sports Medicine (Licence: TX J4075)  | |
| Enumeration Date | 2014-03-10 | 
| Last Update Date | 2018-08-21 |