| NPI | 1619076528 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: CA A72149)  | 
| Additional Taxonomies | 174400000X Specialist (Licence: CA A72149)  | 
| Enumeration Date | 2006-09-21 | 
| Last Update Date | 2024-12-05 |