| NPI | 1679986277 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: MO 2021025372) |
| Additional Taxonomies | 208D00000X General Practice (Licence: MA ETL-6027) |
| 208D00000X General Practice (Licence: IN 01084127A) | |
| Enumeration Date | 2014-06-11 |
| Last Update Date | 2021-11-18 |