| NPI | 1316975725 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: NY 171360) |
| Additional Taxonomies | 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine (Licence: NY 171360) |
| 2081S0010X Physical Medicine & Rehabilitation, Sports Medicine (Licence: NY 171360) | |
| Enumeration Date | 2006-06-28 |
| Last Update Date | 2011-04-13 |