| NPI | 1104130103 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NJ 40QA01735700) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NY 032543) |
| Enumeration Date | 2010-08-02 |
| Last Update Date | 2024-12-19 |