| NPI | 1144567066 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 261QP2000X Clinic/Center, Physical Therapy (Licence: NY 014027-01) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NJ 40QA00518000) |
| Enumeration Date | 2013-01-11 |
| Last Update Date | 2021-06-07 |