| NPI | 1265795959 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: NY 296885) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: PA md456069) |
| Enumeration Date | 2012-06-19 |
| Last Update Date | 2025-11-12 |