| NPI | 1972094563 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: MI 4351048864) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: NE 8242) |
| Enumeration Date | 2018-05-20 |
| Last Update Date | 2022-07-29 |