| NPI | 1376796557 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: PA PT0300518) |
| Additional Taxonomies | 171W00000X Contractor (Licence: NJ 40QA01056900) |
| 2251X0800X Physical Therapist, Orthopedic (Licence: NJ 40QA01056900) | |
| Enumeration Date | 2008-10-31 |
| Last Update Date | 2022-08-19 |