| NPI | 1912174012 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: NJ 25MB09328400) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: PA OS015935) |
| Enumeration Date | 2008-05-08 |
| Last Update Date | 2019-04-03 |