| NPI | 1689810194 |
|---|---|
| Former Name | MARY JANE NATHAN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NJ 40QA00918700) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NY 018639-1) |
| Enumeration Date | 2009-01-05 |
| Last Update Date | 2009-01-05 |