| NPI | 1518214212 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NJ 40QA01441000) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NY 62034769) |
| Enumeration Date | 2012-08-13 |
| Last Update Date | 2017-04-03 |