| NPI | 1891074001 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: NY 276658) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: VA 0101258357) |
| Enumeration Date | 2011-08-05 |
| Last Update Date | 2025-11-24 |