| NPI | 1669748687 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: NY 288716)  | 
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: MN 107036)  | 
| 208100000X Physical Medicine & Rehabilitation (Licence: MN 56925)  | |
| Enumeration Date | 2012-03-23 | 
| Last Update Date | 2021-11-12 |