| NPI | 1235409970 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NJ 40QA01525200) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NY 034216) |
| Enumeration Date | 2012-01-11 |
| Last Update Date | 2022-06-11 |