| NPI | 1063801595 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NY 037396-1) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NJ 40QA01552500) |
| Enumeration Date | 2015-01-21 |
| Last Update Date | 2015-01-21 |