| NPI | 1073624904 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NJ 40QA01231100) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NY 025896) |
| Enumeration Date | 2006-08-31 |
| Last Update Date | 2009-01-07 |