| NPI | 1457772071 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NJ 40QA01575700) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: NY 037268) |
| Enumeration Date | 2013-12-27 |
| Last Update Date | 2019-09-27 |