| NPI | 1205094802 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: NC 2012-01023) |
| Additional Taxonomies | 204R00000X Electrodiagnostic Medicine (Licence: NC 2012-01023) |
| Enumeration Date | 2008-05-30 |
| Last Update Date | 2025-10-05 |