| NPI | 1023407731 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NJ 40QA01579600) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NY 035193) |
| Enumeration Date | 2015-01-19 |
| Last Update Date | 2020-08-14 |