| NPI | 1740926609 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: CT 12442) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: NY 044902) |
| Enumeration Date | 2022-05-12 |
| Last Update Date | 2022-05-12 |