NPI | 1144251893 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: NJ 25MA09606500) |
Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: NY 178853) |
208D00000X General Practice (Licence: NY 178853) | |
208D00000X General Practice (Licence: NJ 25MA09606500) | |
Enumeration Date | 2006-07-05 |
Last Update Date | 2020-06-05 |