| NPI | 1114210085 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: FL ME127530) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: MN 55801) |
| Enumeration Date | 2011-05-25 |
| Last Update Date | 2026-06-16 |