| NPI | 1104147206 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: CA 20A15076) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: IA DO-04624) |
| 208100000X Physical Medicine & Rehabilitation (Licence: CA 15076) | |
| Enumeration Date | 2010-06-13 |
| Last Update Date | 2025-12-12 |