| NPI | 1720262413 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: NY 029415-1) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: NJ 40QA01550900) |
| Enumeration Date | 2007-12-18 |
| Last Update Date | 2015-10-26 |