| NPI | 1215469705 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: TX T7691) |
| Additional Taxonomies | 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine (Licence: TX T7691) |
| 208VP0000X (Licence: TX T7691) | |
| Enumeration Date | 2017-04-03 |
| Last Update Date | 2025-10-10 |