| NPI | 1629572771 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: MO 2022033965) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: UT 11405437-1205) |
| Enumeration Date | 2018-03-22 |
| Last Update Date | 2022-09-07 |