| NPI | 1003152265 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NJ 40Qa01599200) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NY 035781) |
| Enumeration Date | 2012-12-17 |
| Last Update Date | 2020-03-05 |