| NPI | 1629636949 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: MO 2024016631) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IA R-11620) |
| 208100000X Physical Medicine & Rehabilitation (Licence: IA R-11620) | |
| 208100000X Physical Medicine & Rehabilitation (Licence: NY 321092) | |
| Enumeration Date | 2019-06-01 |
| Last Update Date | 2024-08-30 |