| NPI | 1467853739 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MD 24214) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NJ 40QA01453300) |
| Enumeration Date | 2014-09-05 |
| Last Update Date | 2019-01-07 |