| NPI | 1316213408 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: SC 7989) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NJ 40QA01343000) |
| Enumeration Date | 2012-03-22 |
| Last Update Date | 2016-10-12 |