| NPI | 1639465461 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: TX R4398) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: PR 18217) |
| Enumeration Date | 2011-06-20 |
| Last Update Date | 2025-10-13 |