| NPI | 1043557762 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NY 035632) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NJ 40QA01304900) |
| Enumeration Date | 2013-01-15 |
| Last Update Date | 2013-01-15 |