| NPI | 1275004095 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NJ 40QA01945700) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NY 043904) |
| Enumeration Date | 2018-12-06 |
| Last Update Date | 2020-08-20 |