| NPI | 1801464029 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 261QR0401X Clinic/Center, Rehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF) |
| Additional Taxonomies | 283X00000X Rehabilitation Hospital |
| Enumeration Date | 2021-06-14 |
| Last Update Date | 2021-06-14 |