| NPI | 1184905085 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NJ 40QA01470300) |
| Additional Taxonomies | 261QP2000X Clinic/Center, Physical Therapy (Licence: NY 031264-1) |
| Enumeration Date | 2011-09-06 |
| Last Update Date | 2023-01-31 |