| NPI | 1902117617 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: NY 263356) |
| Additional Taxonomies | 207QS0010X Family Medicine, Sports Medicine (Licence: NY 263356) |
| 2081S0010X Physical Medicine & Rehabilitation, Sports Medicine (Licence: NY 263356) | |
| Enumeration Date | 2010-06-28 |
| Last Update Date | 2019-05-24 |