| NPI | 1104872803 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: NY 219013) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: NJ MA72077) |
| Enumeration Date | 2006-05-25 |
| Last Update Date | 2015-04-09 |