| NPI | 1912616699 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: MA 25407) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: NY 047185-01) |
| Enumeration Date | 2022-11-21 |
| Last Update Date | 2022-11-21 |