| NPI | 1104445584 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2081S0010X Physical Medicine & Rehabilitation, Sports Medicine (Licence: NY 337340) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: NY 337340) |
| Enumeration Date | 2020-04-15 |
| Last Update Date | 2025-12-08 |