| NPI | 1902491681 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: TX 2157524)  | 
| Additional Taxonomies | 2081P0010X Physical Medicine & Rehabilitation, Pediatric Rehabilitation Medicine (Licence: TX 2157524)  | 
| Enumeration Date | 2021-03-04 | 
| Last Update Date | 2022-01-14 |