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 |