| NPI | 1609064179 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: DE J1-0002737) |
| Additional Taxonomies | 261QP2000X Clinic/Center, Physical Therapy (Licence: NJ 40QA01136700) |
| Enumeration Date | 2007-10-10 |
| Last Update Date | 2014-10-16 |