| NPI | 1649639345 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: OR 61547) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: ID PT-4048) |
| 208100000X Physical Medicine & Rehabilitation (Licence: NY 039874-1) | |
| Enumeration Date | 2016-02-23 |
| Last Update Date | 2016-02-23 |