| NPI | 1629262035 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 204D00000X Neuromusculoskeletal Medicine & OMM (Licence: NY 252551) |
| Additional Taxonomies | 208D00000X General Practice (Licence: NY 252551) |
| Enumeration Date | 2007-08-29 |
| Last Update Date | 2012-02-07 |