| NPI | 1407385081 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NJ 40QA01836900) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NY 039633) |
| Enumeration Date | 2017-06-07 |
| Last Update Date | 2021-02-08 |