| NPI | 1275053944 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NJ 40QA01621700) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NY 040788-1) |
| Enumeration Date | 2017-06-23 |
| Last Update Date | 2017-06-23 |