| NPI | 1760464663 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: NC 2007-00213) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: WV 21959) |
| 208100000X Physical Medicine & Rehabilitation (Licence: PA MD423882) | |
| Enumeration Date | 2005-11-16 |
| Last Update Date | 2024-12-09 |