| NPI | 1912369992 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: KY 04488) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: KY R4099) |
| 207R00000X Internal Medicine (Licence: KY 04488) | |
| 208100000X Physical Medicine & Rehabilitation (Licence: MT 131835) | |
| Enumeration Date | 2016-03-28 |
| Last Update Date | 2024-05-17 |