| NPI | 1972094563 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2081P0010X Physical Medicine & Rehabilitation Pediatric Rehabilitation Medicine (Licence: NE 36185) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: MI 4351048864) |
| 208100000X Physical Medicine & Rehabilitation (Licence: NE 8242) | |
| Enumeration Date | 2018-05-20 |
| Last Update Date | 2024-06-26 |