| NPI | 1902232358 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: RI MD14843) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: NY 276099) |
| 208100000X Physical Medicine & Rehabilitation (Licence: CA A130761) | |
| Enumeration Date | 2013-09-17 |
| Last Update Date | 2018-09-28 |