| NPI | 1639699911 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: MI 4301509789) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: MI 4301113127) |
| Enumeration Date | 2017-06-27 |
| Last Update Date | 2023-08-17 |