| NPI | 1821385618 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: TX R5541) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: NY 277215) |
| 208100000X Physical Medicine & Rehabilitation (Licence: NJ 25MA09862400) | |
| Enumeration Date | 2011-06-30 |
| Last Update Date | 2024-03-25 |