| NPI | 1255719324 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: NY 325621-01) | 
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: GA 83833) | 
| 208100000X Physical Medicine & Rehabilitation (Licence: MA 1021270) | |
| 208100000X Physical Medicine & Rehabilitation (Licence: WA OP61672550) | |
| Enumeration Date | 2015-05-11 | 
| Last Update Date | 2025-03-19 |