| NPI | 1992933683 |
|---|---|
| Former Name | IDA MEDINA |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: NY 001454-1) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NY 005618-1) |
| Enumeration Date | 2009-07-01 |
| Last Update Date | 2009-07-01 |