| NPI | 1154689008 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2081S0010X Physical Medicine & Rehabilitation, Sports Medicine (Licence: NY 290612) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: NY 290612) |
| Enumeration Date | 2012-04-29 |
| Last Update Date | 2017-07-31 |