| NPI | 1528193091 |
|---|---|
| Former Name | STACY JENNIFER MARCUS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2081P0010X Physical Medicine & Rehabilitation, Pediatric Rehabilitation Medicine (Licence: MD D0063167) |
| Enumeration Date | 2007-02-23 |
| Last Update Date | 2007-10-10 |